<!--
 * @Author: zk
 * @Date: 2021-02-26 10:18:08
 * @LastEditors: zk
 * @LastEditTime: 2021-02-26 11:35:22
 * @Description:
-->
<template>
  <div class="preview">
    <form
      id="form1"
      ref="testForm"
      name="form1"
      onsubmit="return true;"
      action="system/Hdsa0001_saveObj.action"
      method="post"
      enctype="multipart/form-data"
      style="font-size: 16px;"
    >
      <input
        id="form1_hdsa0001_hdsa0001002"
        type="hidden"
        name="hdsa0001.hdsa0001002"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="auditflag"
        type="hidden"
        name="hdsa0001.auditFlag"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="oldIDCard"
        type="hidden"
        name="oldIDCard"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="form1_hdsa0001_hdsa0001024"
        type="hidden"
        name="hdsa0001.hdsa0001024"
        value="1"
        style="font-size: 16px;"
      >

      <input
        id="form1_hdsa0001_hdsa0000035"
        type="hidden"
        name="hdsa0001.hdsa0000035"
        value=""
        style="font-size: 16px;"
      >
      <!-- 结核病 -->
      <input
        id="HDSA0000005"
        type="hidden"
        name="hdsa0001.hdsa0000005"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000007"
        type="hidden"
        name="hdsa0001.hdsa0000007"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000009"
        type="hidden"
        name="hdsa0001.hdsa0000009"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000041"
        type="hidden"
        name="hdsa0001.hdsa0000041"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="form1_hdsa0001_hdsa0001025"
        type="hidden"
        name="hdsa0001.hdsa0001025"
        value="2021-02-04 10:35:31"
        style="font-size: 16px;"
      >

      <input
        id="form1_token"
        type="hidden"
        name="token"
        value="0.3629593351042212"
        style="font-size: 16px;"
      >

      <input
        id="form1_tokenKey"
        type="hidden"
        name="tokenKey"
        value="1612406131061"
        style="font-size: 16px;"
      >

      <table
        width="90%"
        align="center"
        cellpadding="0"
        cellspacing="5"
        border="0"
        style="font-size: 16px;"
      >
        <tbody style="font-size: 16px;">
          <tr style="font-size: 16px;">
            <td class="font_weight" style="font-size: 16px;">
              家庭住址<font color="red" style="font-size: 16px;">*</font>
            </td>
            <td style="font-size: 16px;">
              <div id="jtdz" style="font-size: 16px;">
                <input
                  id="hdsa0001005"
                  type="hidden"
                  name="hdsa0001.hdsa0001005"
                  value="429022001001"
                  style="font-size: 16px;"
                >
                <div
                  id="ext-gen8"
                  class="x-form-field-wrap x-form-field-trigger-wrap"
                  style="width: 200px; font-size: 16px;"
                >
                  <input
                    id="jtdzid"
                    type="text"
                    size="16"
                    autocomplete="off"
                    name="hdsa0001.hdsa0001004"
                    class="x-form-text x-form-field x-trigger-noedit"
                    readonly=""
                    style="width: 175px; font-size: 16px;"
                  >
                </div>
              </div>
            </td>

            <td class="font_weight" style="font-size: 16px;">
              现住地址<font color="red" style="font-size: 16px;">*</font>
            </td>
            <td style="font-size: 16px;">
              <div id="xzdz" style="font-size: 16px;">
                <input
                  id="hdsa0001045"
                  type="hidden"
                  name="hdsa0001.hdsa0001045"
                  value="潜江市渔洋镇陈桥村一组"
                  style="font-size: 16px;"
                >

                <input
                  id="hdsa0001044"
                  type="hidden"
                  name="hdsa0001.hdsa0001044"
                  value="429022001001"
                  style="font-size: 16px;"
                >
                <div
                  id="ext-gen12"
                  class="x-form-field-wrap x-form-field-trigger-wrap"
                  style="width: 200px; font-size: 16px;"
                >
                  <input
                    id="xzdzid"
                    type="text"
                    size="16"
                    autocomplete="off"
                    name="xzdzid"
                    class="x-form-text x-form-field x-trigger-noedit"
                    readonly=""
                    style="width: 175px; font-size: 16px;"
                  >
                </div>
              </div>
            </td>
            <td class="font_weight" style="font-size: 16px;">
              现住地址门牌号<font
                color="black"
                style="font-size: 16px;"
              >*</font>
            </td>
            <td style="font-size: 16px;">
              <input
                id="hdsa0001046"
                type="text"
                name="hdsa0001.hdsa0001046"
                value=""
                class="INPUT3"
                style="font-size: 16px;"
              >
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td class="font_weight" style="font-size: 16px;">
              建档时间<font color="red" style="font-size: 16px;">*</font>
            </td>
            <td style="font-size: 16px;">
              <div id="jdrq" style="font-size: 16px;">
                <input
                  id="hdsa0001019"
                  type="hidden"
                  value="2021-02-04"
                  style="font-size: 16px;"
                >
                <div
                  id="ext-gen6"
                  class="x-form-field-wrap x-form-field-trigger-wrap"
                  style="width: 136px; font-size: 16px;"
                >
                  <input
                    id="jdrqid"
                    type="text"
                    size="10"
                    autocomplete="off"
                    name="hdsa0001.hdsa0001019"
                    class="x-form-text x-form-field x-trigger-noedit"
                    readonly=""
                    style="width: 111px; font-size: 16px;"
                  >
                </div>
              </div>
            </td>
            <td class="font_weight" style="font-size: 16px;">
              户籍地址<font color="red" style="font-size: 16px;">*</font>
            </td>
            <td style="font-size: 16px;">
              <input
                id="hdsa0001017"
                type="hidden"
                name="hdsa0001.hdsa0001017"
                value="渔洋镇陈桥村卫生室"
                style="font-size: 16px;"
              >

              <input
                id="hdsa0001018"
                type="hidden"
                name="hdsa0001.hdsa0001018"
                value="1001013009"
                style="font-size: 16px;"
              >

              <div id="hjdz" style="font-size: 16px;">
                <input
                  id="hdsa0001006"
                  type="hidden"
                  name="hdsa0001.hdsa0001006"
                  value="潜江市"
                  style="font-size: 16px;"
                >

                <input
                  id="hdsa0001007"
                  type="hidden"
                  name="hdsa0001.hdsa0001007"
                  value="429005"
                  style="font-size: 16px;"
                >
                <div
                  id="ext-gen10"
                  class="x-form-field-wrap x-form-field-trigger-wrap"
                  style="width: 200px; font-size: 16px;"
                >
                  <input
                    id="hjdzid"
                    type="text"
                    size="16"
                    autocomplete="off"
                    name="hjdzid"
                    class="x-form-text x-form-field x-trigger-noedit"
                    readonly=""
                    style="width: 175px; font-size: 16px;"
                  >
                </div>
              </div>
            </td>
            <td class="font_weight" style="font-size: 16px;">
              户籍地址门牌号<font
                color="black"
                style="font-size: 16px;"
              >*</font>
            </td>
            <td style="font-size: 16px;">
              <input
                id="hdsa0001047"
                type="text"
                name="hdsa0001.hdsa0001047"
                value=""
                class="INPUT3"
                style="font-size: 16px;"
              >
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td class="font_weight" style="font-size: 16px;">
              建档机构<font color="red" style="font-size: 16px;">*</font>
            </td>
            <td style="font-size: 16px;">
              <div id="jdjg" style="font-size: 16px;">
                <input
                  id="hdsa0001012"
                  type="hidden"
                  name="hdsa0001.hdsa0001012"
                  value="1001"
                  style="font-size: 16px;"
                >

                <input
                  id="hdsa0001011"
                  type="hidden"
                  name="hdsa0001.hdsa0001011"
                  value="潜江市卫生健康委员会"
                  style="font-size: 16px;"
                >
                <div
                  id="ext-gen14"
                  class="x-form-field-wrap x-form-field-trigger-wrap"
                  style="width: 184px; font-size: 16px;"
                >
                  <input
                    id="jdjgid_hdsa0001012"
                    type="text"
                    size="16"
                    autocomplete="off"
                    name="jdjgid_hdsa0001012"
                    class="x-form-text x-form-field x-trigger-noedit"
                    readonly=""
                    style="width: 159px; font-size: 16px;"
                  >
                </div>
              </div>
            </td>
            <td class="font_weight" style="font-size: 16px;">
              建档医生<font color="red" style="font-size: 16px;">*</font>
            </td>
            <td style="font-size: 16px;">
              <div id="jdys" style="font-size: 16px;">
                <input
                  id="hdsa0001013"
                  type="hidden"
                  name="hdsa0001.hdsa0001013"
                  value=""
                  style="font-size: 16px;"
                >

                <input
                  id="hdsa0001027"
                  type="hidden"
                  name="hdsa0001.hdsa0001027"
                  value=""
                  style="font-size: 16px;"
                >
                <div
                  id="ext-gen18"
                  class="x-form-field-wrap x-form-field-trigger-wrap"
                  style="width: 100px; font-size: 16px;"
                >
                  <input
                    id="tname"
                    type="hidden"
                    name="tname"
                    value=""
                    style="font-size: 16px;"
                  ><input
                    id="jdysname"
                    type="text"
                    size="24"
                    autocomplete="off"
                    class="x-form-text x-form-field x-form-empty-field x-form-invalid"
                    style="width: 75px; font-size: 16px;"
                  >
                </div>
              </div>
            </td>
            <td class="font_weight" style="font-size: 16px;">
              责任医生<font color="red" style="font-size: 16px;">*</font>
            </td>
            <td style="font-size: 16px;">
              <div id="zrys" style="font-size: 16px;">
                <input
                  id="hdsa0001014"
                  type="hidden"
                  name="hdsa0001.hdsa0001014"
                  value=""
                  style="font-size: 16px;"
                >
                <input
                  id="hdsa0001028"
                  type="hidden"
                  name="hdsa0001.hdsa0001028"
                  value=""
                  style="font-size: 16px;"
                >
                <div
                  id="ext-gen16"
                  class="x-form-field-wrap x-form-field-trigger-wrap"
                  style="width: 100px; font-size: 16px;"
                >
                  <input
                    id="tname"
                    type="hidden"
                    name="tname"
                    value=""
                    style="font-size: 16px;"
                  ><input
                    id="zrysname"
                    type="text"
                    size="24"
                    autocomplete="off"
                    class="x-form-text x-form-field x-form-empty-field x-form-invalid"
                    style="width: 75px; font-size: 16px;"
                  >
                </div>
              </div>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td style="font-size: 16px;">家庭编号</td>
            <td style="font-size: 16px;">
              <input
                id="hdsa0002002"
                type="text"
                value="A20A20E3BD92C384E05001584E0FE1D1"
                class="INPUT3"
                readonly="true"
                style="font-size: 16px;"
              >
            </td>
            <td style="font-size: 16px;">
              录入人员 <font color="black" style="font-size: 16px;">*</font>
            </td>
            <td style="font-size: 16px;">
              <input
                id="hdsa0001031"
                type="text"
                value="信息中心"
                name="hdsa0001.hdsa0001031"
                readonly="true"
                class="INPUT"
                style="font-size: 16px;"
              >
            </td>
            <td style="font-size: 16px;">管辖机构</td>
            <td style="font-size: 16px;">
              <input
                type="text"
                value="渔洋镇陈桥村卫生室"
                disabled="true"
                readonly="true"
                class="INPUT"
                style="font-size: 16px;"
              >
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td style="font-size: 16px;">
              录入时间 <font color="black" style="font-size: 16px;">*</font>
            </td>
            <td style="font-size: 16px;">
              <input
                id="hdsa0001021"
                type="text"
                value="2021-02-04 10:35:31"
                name="hdsa0001.hdsa0001021"
                readonly="true"
                class="INPUT"
                style="font-size: 16px;"
              >
            </td>

            <td style="font-size: 16px;">
              修改时间 <font color="black" style="font-size: 16px;">*</font>
            </td>
            <td style="font-size: 16px;">
              <input
                id="hdsa0001025"
                type="text"
                value="2021-02-04 10:35:31"
                readonly="true"
                class="INPUT2"
                style="font-size: 16px;"
              >
            </td>
          </tr>
        </tbody>
      </table>
      <hr style="font-size: 16px;">
      <h2 align="center" style="font-size: 16px;">
        <span class="STYLE1" style="font-size: 16px;">个人基本信息表</span>
      </h2>

      <input
        id="guid"
        type="hidden"
        name="hdsa0001.guid"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="hdsa0001016"
        type="hidden"
        name="hdsa0001.hdsa0001016"
        value="9040017275"
        style="font-size: 16px;"
      >

      <input
        id="hdsa0001015"
        type="hidden"
        name="hdsa0001.hdsa0001015"
        value="1001"
        style="font-size: 16px;"
      >

      <input
        id="hdsa0001026"
        type="hidden"
        name="hdsa0001.hdsa0001026"
        value="A20A20E3BD92C384E05001584E0FE1D1"
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000002"
        type="hidden"
        name="hdsa0001.hdsa0000002"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000003"
        type="hidden"
        name="hdsa0001.hdsa0000003"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000004"
        type="hidden"
        name="hdsa0001.hdsa0000004"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000006"
        type="hidden"
        name="hdsa0001.hdsa0000006"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000008"
        type="hidden"
        name="hdsa0001.hdsa0000008"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000010"
        type="hidden"
        name="hdsa0001.hdsa0000010"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000011"
        type="hidden"
        name="hdsa0001.hdsa0000011"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000012"
        type="hidden"
        name="hdsa0001.hdsa0000012"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000013"
        type="hidden"
        name="hdsa0001.hdsa0000013"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000014"
        type="hidden"
        name="hdsa0001.hdsa0000014"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000015"
        type="hidden"
        name="hdsa0001.hdsa0000015"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000016"
        type="hidden"
        name="hdsa0001.hdsa0000016"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000017"
        type="hidden"
        name="hdsa0001.hdsa0000017"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000018"
        type="hidden"
        name="hdsa0001.hdsa0000018"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000019"
        type="hidden"
        name="hdsa0001.hdsa0000019"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000020"
        type="hidden"
        name="hdsa0001.hdsa0000020"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000021"
        type="hidden"
        name="hdsa0001.hdsa0000021"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000022"
        type="hidden"
        name="hdsa0001.hdsa0000022"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000023"
        type="hidden"
        name="hdsa0001.hdsa0000023"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000024"
        type="hidden"
        name="hdsa0001.hdsa0000024"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000025"
        type="hidden"
        name="hdsa0001.hdsa0000025"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000026"
        type="hidden"
        name="hdsa0001.hdsa0000026"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000027"
        type="hidden"
        name="hdsa0001.hdsa0000027"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000028"
        type="hidden"
        name="hdsa0001.hdsa0000028"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000029"
        type="hidden"
        name="hdsa0001.hdsa0000029"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000030"
        type="hidden"
        name="hdsa0001.hdsa0000030"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000031"
        type="hidden"
        name="hdsa0001.hdsa0000031"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000032"
        type="hidden"
        name="hdsa0001.hdsa0000032"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000033"
        type="hidden"
        name="hdsa0001.hdsa0000033"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000034"
        type="hidden"
        name="hdsa0001.hdsa0000034"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0002002"
        type="hidden"
        name="hdsa0001.hdsa0002002"
        value="A20A20E3BD92C384E05001584E0FE1D1"
        style="font-size: 16px;"
      >

      <input
        id="HDSB0503004"
        type="hidden"
        name="hdsa0001.hdsb0503004"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA000101008"
        type="hidden"
        name="hdsa0001.hdsa000101008"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA000101047"
        type="hidden"
        name="hdsa0001.hdsa000101047"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="ISPOOR"
        type="hidden"
        name="hdsa0001.ispoor"
        value="0"
        style="font-size: 16px;"
      >

      <input
        id="JKPOPULATIONFLAG"
        type="hidden"
        name="hdsa0001.jkPopulationFlag"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000040"
        type="hidden"
        name="hdsa0001.hdsa0000040"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000042"
        type="hidden"
        name="hdsa0001.hdsa0000042"
        value=""
        style="font-size: 16px;"
      >

      <input
        id="HDSA0000043"
        type="hidden"
        name="hdsa0001.hdsa0000043"
        value=""
        style="font-size: 16px;"
      >

      <table
        width="90%"
        align="center"
        cellpadding="0"
        cellspacing="0"
        style="font-size: 16px;"
      >
        <tbody style="font-size: 16px;">
          <tr height="25" style="font-size: 16px;">
            <td colspan="2" align="right" style="font-size: 16px;">
              <span
                class="STYLE1"
                style="font-size: 16px;"
              >姓名<span class="STYLE3" style="font-size: 16px;" /><font
                color="red"
                style="font-size: 16px;"
              >*</font></span>：
            </td>
            <td colspan="3" align="left" style="font-size: 16px;">
              <input
                id="hdsa0001001"
                type="text"
                name="hdsa0001.hdsa0001001"
                size="10"
                maxlength="20"
                value=""
                class="line validate[required,length[0,20]]"
                style="font-size: 16px;"
              >
            </td>
            <td align="right" class="STYLE1" style="font-size: 16px;">
              居民健康档案号：
            </td>
            <td align="left" style="font-size: 16px;">
              <input
                id="hdsa0001002"
                type="text"
                value=""
                class="INPUT3"
                readonly="true"
                style="font-size: 16px;"
              >
            </td>

            <td align="left" style="font-size: 16px;">
              <span class="STYLE1" style="font-size: 16px;">医保号</span>
            </td>
            <td align="left" style="font-size: 16px;">
              &nbsp;
              <input
                id="form1_hdsa0001_hdsa0001032"
                type="text"
                name="hdsa0001.hdsa0001032"
                size="10"
                maxlength="20"
                value=""
                class="line"
                style="font-size: 16px;"
              >
            </td>
            <td align="right" style="font-size: 16px;">
              <span class="STYLE1" style="font-size: 16px;">编号</span>：
            </td>
            <td colspan="2" style="font-size: 16px;">
              <input
                id="form1_hdsa000101_hdsa000101001"
                type="text"
                name="hdsa000101.hdsa000101001"
                maxlength="20"
                value=""
                class="line "
                style="font-size: 16px;"
              >
            </td>
          </tr>
        </tbody>
      </table>

      <table
        width="90%"
        align="center"
        border="1"
        cellspacing="0"
        cellpadding="0"
        bordercolor="#000000"
        style="border-collapse: collapse; font-size: 16px;"
      >
        <tbody style="font-size: 16px;">
          <tr style="font-size: 16px;">
            <td height="30" colspan="2" align="center" style="font-size: 16px;">
              <span
                class="font_weight"
                style="font-size: 16px;"
              >性别<font color="red" style="font-size: 16px;">*</font></span>
            </td>
            <td height="30" colspan="2" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">
                <input
                  id="hdsa0001009"
                  type="hidden"
                  name="hdsa0001.hdsa0001009"
                  value="未说明的性别"
                  style="font-size: 16px;"
                >

                <input
                  id="hdsa0001.hdsa0001008-1"
                  type="checkbox"
                  name="hdsa0001.hdsa0001008"
                  value="1"
                  onclick="checkedThis(this,'hdsa0001.hdsa0001008','hdsa0001.hdsa0001008','hdsa0001.hdsa0001009')"
                  disabled=""
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa0001.hdsa0001008-1"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >男</label>
                <input
                  id="hdsa0001.hdsa0001008-2"
                  type="checkbox"
                  name="hdsa0001.hdsa0001008"
                  value="2"
                  onclick="checkedThis(this,'hdsa0001.hdsa0001008','hdsa0001.hdsa0001008','hdsa0001.hdsa0001009')"
                  disabled=""
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa0001.hdsa0001008-2"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >女</label>
                <input
                  id="hdsa0001.hdsa0001008-3"
                  type="checkbox"
                  name="hdsa0001.hdsa0001008"
                  value="3"
                  checked="checked"
                  onclick="checkedThis(this,'hdsa0001.hdsa0001008','hdsa0001.hdsa0001008','hdsa0001.hdsa0001009')"
                  disabled=""
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa0001.hdsa0001008-3"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >未说明的性别</label>
                <input
                  id="hdsa0001.hdsa0001008-4"
                  type="checkbox"
                  name="hdsa0001.hdsa0001008"
                  value="0"
                  onclick="checkedThis(this,'hdsa0001.hdsa0001008','hdsa0001.hdsa0001008','hdsa0001.hdsa0001009')"
                  disabled=""
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa0001.hdsa0001008-4"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >未知的性别</label>
              </span>
            </td>
            <td height="30" align="center" style="font-size: 16px;">
              <span
                class="font_weight"
                style="font-size: 16px;"
              >出生日期<font
                color="red"
                style="font-size: 16px;"
              >*</font></span>
            </td>
            <td style="font-size: 16px;">
              &nbsp;
              <input
                id="hdsa0001010"
                type="text"
                value=""
                name="hdsa0001.hdsa0001010"
                class="line validate[required,custom[date] ]"
                style="font-size: 16px;"
              >
            </td>
            <td style="font-size: 16px;">
              <span class="font_weight" style="font-size: 16px;">精准扶贫</span><font color="red" style="font-size: 16px;">*</font>&nbsp;&nbsp;
              <input
                id="hdsa0001.ispoor-1"
                type="checkbox"
                name="hdsa0001.ispoor"
                value="0"
                checked="checked"
                onclick="checkedThis(this,'hdsa0001.ispoor','hdsa0001.ispoor','hdsa0001.ispoor')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa0001.ispoor-1"
                class="checkboxLabel"
                style="font-size: 16px;"
              >否</label>
              <input
                id="hdsa0001.ispoor-2"
                type="checkbox"
                name="hdsa0001.ispoor"
                value="1"
                onclick="checkedThis(this,'hdsa0001.ispoor','hdsa0001.ispoor','hdsa0001.ispoor')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa0001.ispoor-2"
                class="checkboxLabel"
                style="font-size: 16px;"
              >是</label>
            </td>
            <td colspan="3" rowspan="4" align="center" style="font-size: 16px;">
              <input
                id="form1_hdsa0001_hdsa0001037"
                type="hidden"
                name="hdsa0001.hdsa0001037"
                value="images/defaultprofile.png"
                style="font-size: 16px;"
              >

              <div id="preview" title="点击上传照片" style="font-size: 16px;" />
              <font color="red" style="font-size: 16px;">请选择登记照</font><input
                id="upload"
                type="file"
                name="upload"
                size="1"
                value=""
                accept="image/bmp,image/png,image/gif,image/jpeg"
                title="照片上传"
                onchange="preview(this)"
                style="font-size: 16px;"
              >
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td height="30" colspan="2" align="center" style="font-size: 16px;">
              <span class="font_weight" style="font-size: 16px;">身份证号</span><font color="red" style="font-size: 16px;">*</font>
            </td>
            <td colspan="2" style="font-size: 16px;">
              <input
                id="hdsa0001003"
                type="text"
                value=""
                name="hdsa0001.hdsa0001003"
                class="line "
                onblur="checkId(this.value)"
                style="font-size: 16px;"
              >
            </td>

            <td align="center" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">工作单位</span>
            </td>
            <td colspan="2" style="font-size: 16px;">
              <input
                id="hdsa000101004"
                type="text"
                name="hdsa000101.hdsa000101004"
                size="40"
                maxlength="50"
                value=""
                class="line"
                style="font-size: 16px;"
              >
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td height="30" colspan="2" align="center" style="font-size: 16px;">
              <span class="font_weight" style="font-size: 16px;">本人电话</span><font color="red" style="font-size: 16px;">*</font>
            </td>
            <td style="font-size: 16px;">
              <input
                id="hdsa0001029"
                type="text"
                name="hdsa0001.hdsa0001029"
                maxlength="20"
                value=""
                class="line"
                style="font-size: 16px;"
              >
            </td>
            <td align="center" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">联系人姓名</span>
            </td>
            <td align="center" style="font-size: 16px;">
              <input
                id="hdsa0001048"
                type="text"
                name="hdsa0001.hdsa0001048"
                size="8"
                maxlength="20"
                value=""
                class="line"
                style="font-size: 16px;"
              >
            </td>
            <td style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">联系人电话</span>
            </td>
            <td style="font-size: 16px;">
              <input
                id="hdsa0001049"
                type="text"
                name="hdsa0001.hdsa0001049"
                maxlength="20"
                value=""
                class="line"
                style="font-size: 16px;"
              >
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td height="30" colspan="2" align="center" style="font-size: 16px;">
              <span
                class="font_weight"
                style="font-size: 16px;"
              >常住类型<font
                color="red"
                style="font-size: 16px;"
              >*</font></span>
            </td>
            <td colspan="2" nowrap="" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">
                <input
                  id="hdsa000101.hdsa000101009"
                  type="hidden"
                  name="hdsa000101.hdsa000101009"
                  value=""
                  style="font-size: 16px;"
                >

                常住人口 (
                <input
                  id="hdsa000101.hdsa000101008-1"
                  type="checkbox"
                  name="hdsa000101.hdsa000101008"
                  value="0"
                  checked="checked"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101008','hdsa000101.hdsa000101008','hdsa000101.hdsa000101009')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101008-1"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >户籍</label>
                <input
                  id="hdsa000101.hdsa000101008-2"
                  type="checkbox"
                  name="hdsa000101.hdsa000101008"
                  value="1"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101008','hdsa000101.hdsa000101008','hdsa000101.hdsa000101009')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101008-2"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >非户籍</label>

                )
                <input
                  id="hdsa000101.hdsa000101008-1"
                  type="checkbox"
                  name="hdsa000101.hdsa000101008"
                  value="2"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101008','hdsa000101.hdsa000101008','hdsa000101.hdsa000101009')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101008-1"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >流动人口</label>
              </span>
            </td>
            <td align="center" style="font-size: 16px;">
              <span
                class="font_weight"
                style="font-size: 16px;"
              >民族<font color="red" style="font-size: 16px;">*</font></span>
            </td>
            <td colspan="2" align="center" style="font-size: 16px;">
              &nbsp;
              <span class="STYLE2" style="font-size: 16px;">
                <input
                  id="hdsa000101.hdsa000101011"
                  type="hidden"
                  name="hdsa000101.hdsa000101011"
                  value="汉族"
                  style="font-size: 16px;"
                >

                <input
                  id="hdsa000101.hdsa000101010-1"
                  type="checkbox"
                  name="hdsa000101.hdsa000101010"
                  value="0"
                  checked="checked"
                  onclick="checkedThisByJktj(this,'hdsa000101.hdsa000101010','hdsa000101.hdsa000101010','hdsa000101.hdsa000101011' ,'hdsa000101012','','','','hdsa000101.hdsa000101010-2');setTextDis(this)"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101010-1"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >汉族</label>
                <input
                  id="hdsa000101.hdsa000101010-2"
                  type="checkbox"
                  name="hdsa000101.hdsa000101010"
                  value="1"
                  onclick="checkedThisByJktj(this,'hdsa000101.hdsa000101010','hdsa000101.hdsa000101010','hdsa000101.hdsa000101011' ,'hdsa000101012','','','','hdsa000101.hdsa000101010-2');setTextDis(this)"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101010-2"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >少数民族</label>

                &nbsp;&nbsp;
                <input
                  id="hdsa000101012"
                  type="text"
                  readonly="readonly"
                  value=""
                  onclick="isqtzz('hdsa000101.hdsa000101010-2','hdsa000101012')"
                  name="hdsa000101.hdsa000101012"
                  cssclass="line"
                  size="16"
                  maxlength="20"
                  style="font-size: 16px;"
                >
              </span>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td height="30" colspan="2" align="center" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">血型</span>
            </td>
            <td colspan="8" style="font-size: 16px;">
              <table style="font-size: 16px;">
                <tbody style="font-size: 16px;">
                  <tr style="font-size: 16px;">
                    <td class="STYLE2" style="font-size: 16px;">
                      <input
                        id="hdsa000101.hdsa000101014"
                        type="hidden"
                        name="hdsa000101.hdsa000101014"
                        value=""
                        style="font-size: 16px;"
                      >

                      <input
                        id="hdsa000101.hdsa000101013-1"
                        type="checkbox"
                        name="hdsa000101.hdsa000101013"
                        value="0"
                        onclick="checkedThis(this,'hdsa000101.hdsa000101013','hdsa000101.hdsa000101013','hdsa000101.hdsa000101014')"
                        style="font-size: 16px;"
                      >
                      <label
                        for="hdsa000101.hdsa000101013-1"
                        class="checkboxLabel"
                        style="font-size: 16px;"
                      >A型</label>
                      <input
                        id="hdsa000101.hdsa000101013-2"
                        type="checkbox"
                        name="hdsa000101.hdsa000101013"
                        value="1"
                        onclick="checkedThis(this,'hdsa000101.hdsa000101013','hdsa000101.hdsa000101013','hdsa000101.hdsa000101014')"
                        style="font-size: 16px;"
                      >
                      <label
                        for="hdsa000101.hdsa000101013-2"
                        class="checkboxLabel"
                        style="font-size: 16px;"
                      >B型</label>
                      <input
                        id="hdsa000101.hdsa000101013-3"
                        type="checkbox"
                        name="hdsa000101.hdsa000101013"
                        value="2"
                        onclick="checkedThis(this,'hdsa000101.hdsa000101013','hdsa000101.hdsa000101013','hdsa000101.hdsa000101014')"
                        style="font-size: 16px;"
                      >
                      <label
                        for="hdsa000101.hdsa000101013-3"
                        class="checkboxLabel"
                        style="font-size: 16px;"
                      >O型</label>
                      <input
                        id="hdsa000101.hdsa000101013-4"
                        type="checkbox"
                        name="hdsa000101.hdsa000101013"
                        value="3"
                        onclick="checkedThis(this,'hdsa000101.hdsa000101013','hdsa000101.hdsa000101013','hdsa000101.hdsa000101014')"
                        style="font-size: 16px;"
                      >
                      <label
                        for="hdsa000101.hdsa000101013-4"
                        class="checkboxLabel"
                        style="font-size: 16px;"
                      >AB型</label>
                      <input
                        id="hdsa000101.hdsa000101013-5"
                        type="checkbox"
                        name="hdsa000101.hdsa000101013"
                        value="4"
                        checked="checked"
                        onclick="checkedThis(this,'hdsa000101.hdsa000101013','hdsa000101.hdsa000101013','hdsa000101.hdsa000101014')"
                        style="font-size: 16px;"
                      >
                      <label
                        for="hdsa000101.hdsa000101013-5"
                        class="checkboxLabel"
                        style="font-size: 16px;"
                      >不详</label>
                    </td>
                    <td class="STYLE2" style="font-size: 16px;">
                      /RH：
                    </td>
                    <td class="STYLE2" style="font-size: 16px;">
                      <label style="font-size: 16px;">
                        <input
                          id="hdsa000101.hdsa000101016"
                          type="hidden"
                          name="hdsa000101.hdsa000101016"
                          value=""
                          style="font-size: 16px;"
                        >

                        <input
                          id="hdsa000101.hdsa000101015-1"
                          type="checkbox"
                          name="hdsa000101.hdsa000101015"
                          value="0"
                          onclick="checkedThis(this,'hdsa000101.hdsa000101015','hdsa000101.hdsa000101013','hdsa000101.hdsa000101016')"
                          style="font-size: 16px;"
                        >
                        <label
                          for="hdsa000101.hdsa000101015-1"
                          class="checkboxLabel"
                          style="font-size: 16px;"
                        >阴性</label>
                        <input
                          id="hdsa000101.hdsa000101015-2"
                          type="checkbox"
                          name="hdsa000101.hdsa000101015"
                          value="1"
                          onclick="checkedThis(this,'hdsa000101.hdsa000101015','hdsa000101.hdsa000101013','hdsa000101.hdsa000101016')"
                          style="font-size: 16px;"
                        >
                        <label
                          for="hdsa000101.hdsa000101015-2"
                          class="checkboxLabel"
                          style="font-size: 16px;"
                        >阳性</label>
                        <input
                          id="hdsa000101.hdsa000101015-3"
                          type="checkbox"
                          name="hdsa000101.hdsa000101015"
                          value="2"
                          checked="checked"
                          onclick="checkedThis(this,'hdsa000101.hdsa000101015','hdsa000101.hdsa000101013','hdsa000101.hdsa000101016')"
                          style="font-size: 16px;"
                        >
                        <label
                          for="hdsa000101.hdsa000101015-3"
                          class="checkboxLabel"
                          style="font-size: 16px;"
                        >不详</label>
                      </label>
                    </td>
                  </tr>
                </tbody>
              </table>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td height="30" colspan="2" align="center" style="font-size: 16px;">
              <span
                class="font_weight"
                style="font-size: 16px;"
              >文化程度<font
                color="red"
                style="font-size: 16px;"
              >*</font></span>
            </td>
            <td colspan="8" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">
                <input
                  id="hdsa000101.hdsa000101018"
                  type="hidden"
                  name="hdsa000101.hdsa000101018"
                  value=""
                  style="font-size: 16px;"
                >

                <input
                  id="hdsa000101.hdsa000101017-1"
                  type="checkbox"
                  name="hdsa000101.hdsa000101017"
                  value="0"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101017','hdsa000101.hdsa000101017','hdsa000101.hdsa000101018')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101017-1"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >研究生</label>
                <input
                  id="hdsa000101.hdsa000101017-2"
                  type="checkbox"
                  name="hdsa000101.hdsa000101017"
                  value="1"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101017','hdsa000101.hdsa000101017','hdsa000101.hdsa000101018')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101017-2"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >大学本科</label>
                <input
                  id="hdsa000101.hdsa000101017-3"
                  type="checkbox"
                  name="hdsa000101.hdsa000101017"
                  value="2"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101017','hdsa000101.hdsa000101017','hdsa000101.hdsa000101018')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101017-3"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >大学专科和专科学校</label>
                <input
                  id="hdsa000101.hdsa000101017-4"
                  type="checkbox"
                  name="hdsa000101.hdsa000101017"
                  value="3"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101017','hdsa000101.hdsa000101017','hdsa000101.hdsa000101018')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101017-4"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >中等专业学校</label>
                <input
                  id="hdsa000101.hdsa000101017-5"
                  type="checkbox"
                  name="hdsa000101.hdsa000101017"
                  value="4"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101017','hdsa000101.hdsa000101017','hdsa000101.hdsa000101018')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101017-5"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >技工学校</label>
                <input
                  id="hdsa000101.hdsa000101017-6"
                  type="checkbox"
                  name="hdsa000101.hdsa000101017"
                  value="5"
                  checked="checked"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101017','hdsa000101.hdsa000101017','hdsa000101.hdsa000101018')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101017-6"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >高中</label>
                <input
                  id="hdsa000101.hdsa000101017-7"
                  type="checkbox"
                  name="hdsa000101.hdsa000101017"
                  value="6"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101017','hdsa000101.hdsa000101017','hdsa000101.hdsa000101018')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101017-7"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >初中</label>
                <input
                  id="hdsa000101.hdsa000101017-8"
                  type="checkbox"
                  name="hdsa000101.hdsa000101017"
                  value="7"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101017','hdsa000101.hdsa000101017','hdsa000101.hdsa000101018')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101017-8"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >小学</label>
                <input
                  id="hdsa000101.hdsa000101017-9"
                  type="checkbox"
                  name="hdsa000101.hdsa000101017"
                  value="8"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101017','hdsa000101.hdsa000101017','hdsa000101.hdsa000101018')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101017-9"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >文盲或半文盲</label>
                <input
                  id="hdsa000101.hdsa000101017-10"
                  type="checkbox"
                  name="hdsa000101.hdsa000101017"
                  value="9"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101017','hdsa000101.hdsa000101017','hdsa000101.hdsa000101018')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101017-10"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >不详</label>
              </span>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td height="30" colspan="2" align="center" style="font-size: 16px;">
              <span
                class="font_weight"
                style="font-size: 16px;"
              >职业<font color="red" style="font-size: 16px;">*</font></span>
            </td>
            <td colspan="8" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">
                <input
                  id="hdsa000101.hdsa000101020"
                  type="hidden"
                  name="hdsa000101.hdsa000101020"
                  value=""
                  style="font-size: 16px;"
                >

                <input
                  id="hdsa000101.hdsa000101019-1"
                  type="checkbox"
                  name="hdsa000101.hdsa000101019"
                  value="0"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101019','hdsa000101.hdsa000101019','hdsa000101.hdsa000101020')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101019-1"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >
                  国家机关、党群组织、企业、事业单位负责人</label>
                <input
                  id="hdsa000101.hdsa000101019-2"
                  type="checkbox"
                  name="hdsa000101.hdsa000101019"
                  value="1"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101019','hdsa000101.hdsa000101019','hdsa000101.hdsa000101020')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101019-2"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >专业技术人员</label>
                <input
                  id="hdsa000101.hdsa000101019-3"
                  type="checkbox"
                  name="hdsa000101.hdsa000101019"
                  value="2"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101019','hdsa000101.hdsa000101019','hdsa000101.hdsa000101020')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101019-3"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >办事人员和有关人员</label>
                <input
                  id="hdsa000101.hdsa000101019-4"
                  type="checkbox"
                  name="hdsa000101.hdsa000101019"
                  value="3"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101019','hdsa000101.hdsa000101019','hdsa000101.hdsa000101020')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101019-4"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >商业、服务业人员</label>
                <input
                  id="hdsa000101.hdsa000101019-5"
                  type="checkbox"
                  name="hdsa000101.hdsa000101019"
                  value="4"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101019','hdsa000101.hdsa000101019','hdsa000101.hdsa000101020')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101019-5"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >农、林、牧、渔、水利业生产人员</label>
                <input
                  id="hdsa000101.hdsa000101019-6"
                  type="checkbox"
                  name="hdsa000101.hdsa000101019"
                  value="5"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101019','hdsa000101.hdsa000101019','hdsa000101.hdsa000101020')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101019-6"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >生产、运输设备操作人员及有关人员</label>
                <input
                  id="hdsa000101.hdsa000101019-7"
                  type="checkbox"
                  name="hdsa000101.hdsa000101019"
                  value="6"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101019','hdsa000101.hdsa000101019','hdsa000101.hdsa000101020')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101019-7"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >军人</label>
                <input
                  id="hdsa000101.hdsa000101019-8"
                  type="checkbox"
                  name="hdsa000101.hdsa000101019"
                  value="7"
                  checked="checked"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101019','hdsa000101.hdsa000101019','hdsa000101.hdsa000101020')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101019-8"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >不便分类的其他从业人员</label>
                <input
                  id="hdsa000101.hdsa000101019-9"
                  type="checkbox"
                  name="hdsa000101.hdsa000101019"
                  value="8"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101019','hdsa000101.hdsa000101019','hdsa000101.hdsa000101020')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101019-9"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >无职业</label>
              </span>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td height="30" colspan="2" align="center" style="font-size: 16px;">
              <span
                class="font_weight"
                style="font-size: 16px;"
              >婚姻状况<font
                color="red"
                style="font-size: 16px;"
              >*</font></span>
            </td>
            <td colspan="8" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">
                <input
                  id="hdsa000101.hdsa000101022"
                  type="hidden"
                  name="hdsa000101.hdsa000101022"
                  value=""
                  style="font-size: 16px;"
                >

                <input
                  id="hdsa000101.hdsa000101021-1"
                  type="checkbox"
                  name="hdsa000101.hdsa000101021"
                  value="0"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101021','hdsa000101.hdsa000101021','hdsa000101.hdsa000101022')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101021-1"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >未婚</label>
                <input
                  id="hdsa000101.hdsa000101021-2"
                  type="checkbox"
                  name="hdsa000101.hdsa000101021"
                  value="1"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101021','hdsa000101.hdsa000101021','hdsa000101.hdsa000101022')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101021-2"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >
                  已婚</label>
                <input
                  id="hdsa000101.hdsa000101021-3"
                  type="checkbox"
                  name="hdsa000101.hdsa000101021"
                  value="2"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101021','hdsa000101.hdsa000101021','hdsa000101.hdsa000101022')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101021-3"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >丧偶</label>
                <input
                  id="hdsa000101.hdsa000101021-4"
                  type="checkbox"
                  name="hdsa000101.hdsa000101021"
                  value="3"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101021','hdsa000101.hdsa000101021','hdsa000101.hdsa000101022')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101021-4"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >离婚</label>
                <input
                  id="hdsa000101.hdsa000101021-5"
                  type="checkbox"
                  name="hdsa000101.hdsa000101021"
                  value="4"
                  checked="checked"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101021','hdsa000101.hdsa000101021','hdsa000101.hdsa000101022')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101021-5"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >未说明的婚姻状况</label>
              </span>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td height="52" colspan="2" align="center" style="font-size: 16px;">
              <span
                class="STYLE2"
                style="font-size: 16px;"
              >医疗费用 支付方式</span>
            </td>
            <td colspan="8" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">
                <input
                  id="yl_1"
                  type="checkbox"
                  name="hdsa000101.payWaylist[0].hdsa00010101002"
                  value="0,城镇职工基本医疗保险"
                  onclick="clearByCheckedId('yl_8','form1_hdsa000101_hdsa000101023')"
                  style="font-size: 16px;"
                >
                城镇职工基本医疗保险

                <input
                  id="yl_2"
                  type="checkbox"
                  name="hdsa000101.payWaylist[1].hdsa00010101002"
                  onclick="clearByCheckedId('yl_8','form1_hdsa000101_hdsa000101023')"
                  value="1,城镇居民基本医疗保险"
                  style="font-size: 16px;"
                >
                城镇居民基本医疗保险

                <input
                  id="yl_3"
                  type="checkbox"
                  name="hdsa000101.payWaylist[2].hdsa00010101002"
                  onclick="clearByCheckedId('yl_8','form1_hdsa000101_hdsa000101023')"
                  value="2,新型农村合作医疗"
                  style="font-size: 16px;"
                >
                新型农村合作医疗

                <input
                  id="yl_4"
                  type="checkbox"
                  name="hdsa000101.payWaylist[3].hdsa00010101002"
                  onclick="clearByCheckedId('yl_8','form1_hdsa000101_hdsa000101023')"
                  value="3,贫困救助"
                  style="font-size: 16px;"
                >
                贫困救助

                <input
                  id="yl_5"
                  type="checkbox"
                  name="hdsa000101.payWaylist[4].hdsa00010101002"
                  onclick="clearByCheckedId('yl_8','form1_hdsa000101_hdsa000101023')"
                  value="4,商业医疗保险"
                  style="font-size: 16px;"
                >
                商业医疗保险

                <input
                  id="yl_6"
                  type="checkbox"
                  name="hdsa000101.payWaylist[5].hdsa00010101002"
                  onclick="clearByCheckedId('yl_8','form1_hdsa000101_hdsa000101023')"
                  value="5,全公费"
                  style="font-size: 16px;"
                >
                全公费

                <input
                  id="yl_7"
                  type="checkbox"
                  name="hdsa000101.payWaylist[6].hdsa00010101002"
                  onclick="clearByCheckedId('yl_8','form1_hdsa000101_hdsa000101023')"
                  value="6,全自费"
                  style="font-size: 16px;"
                >
                全自费
                <br style="font-size: 16px;">
                <input
                  id="yl_8"
                  type="checkbox"
                  name="hdsa000101.payWaylist[7].hdsa00010101002"
                  value="7,其他"
                  onclick="selectOther('this','hdsa000101023');isqtzz('yl_8','hdsa000101hdsa000101023')"
                  style="font-size: 16px;"
                >
                其他

                <input
                  id="hdsa000101hdsa000101023"
                  type="text"
                  readonly="readonly"
                  value=""
                  onclick="isqtzz('yl_8','hdsa000101hdsa000101023')"
                  name="hdsa000101.hdsa000101023"
                  cssclass="line"
                  size="12"
                  maxlength="50"
                  style="font-size: 16px;"
                >
              </span>
            </td>
          </tr>

          <tr style="font-size: 16px;">
            <td height="39" colspan="2" align="center" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">药物过敏史</span>
            </td>
            <td colspan="8" style="font-size: 16px;">
              <span id="ywgms" class="STYLE2" style="font-size: 16px;">
                <input
                  id="hdsa000101.hdsa000101024-1"
                  type="checkbox"
                  name="hdsa000101.hdsa000101024"
                  value="0"
                  checked="checked"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101024','hdsa000101.hdsa000101024','hdsa000101.hdsa000101025');checkBoxChecd2('ywgms','2','hdsa000101hdsa000101026')"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101024-1"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >无</label>

                <input
                  id="QMS"
                  onclick="checkedThis3(this,'hdsa000101.hdsa000101024','hdsa000101.hdsa000101025')"
                  type="checkbox"
                  name="hdsa000101.allergenslist[0].hdsa00010102002"
                  value="0,青霉素"
                  style="font-size: 16px;"
                >
                青霉素
                <input
                  id="HA"
                  onclick="checkedThis3(this,'hdsa000101.hdsa000101024','hdsa000101.hdsa000101025')"
                  type="checkbox"
                  name="hdsa000101.allergenslist[1].hdsa00010102002"
                  value="1,磺胺"
                  style="font-size: 16px;"
                >
                磺胺
                <input
                  id="LMS"
                  onclick="checkedThis3(this,'hdsa000101.hdsa000101024','hdsa000101.hdsa000101025')"
                  type="checkbox"
                  name="hdsa000101.allergenslist[2].hdsa00010102002"
                  value="2,链霉素"
                  style="font-size: 16px;"
                >
                链霉素
                <input
                  id="QT"
                  onclick="checkedThis3(this,'hdsa000101.hdsa000101024','hdsa000101.hdsa000101025');isqtzz('QT','hdsa000101hdsa000101026')"
                  type="checkbox"
                  name="hdsa000101.allergenslist[3].hdsa00010102002"
                  value="3,其他 "
                  style="font-size: 16px;"
                >
                其他
                <input
                  id="hdsa000101hdsa000101026"
                  type="text"
                  readonly="readonly"
                  value=""
                  onclick="isqtzz('QT','hdsa000101hdsa000101026')"
                  name="hdsa000101.hdsa000101026"
                  cssclass="line"
                  size="12"
                  maxlength="50"
                  style="font-size: 16px;"
                >
                <input
                  id="hdsa000101.hdsa000101025"
                  type="hidden"
                  name="hdsa000101.hdsa000101025"
                  value=""
                  style="font-size: 16px;"
                >
              </span>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td height="30" colspan="2" align="center" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">暴露史</span>
            </td>
            <td colspan="8" style="font-size: 16px;">
              <span id="bls" class="STYLE2" style="font-size: 16px;">
                <input
                  id="hdsa000101.hdsa000101036-1"
                  type="checkbox"
                  name="hdsa000101.hdsa000101036"
                  value="0"
                  checked="checked"
                  onclick="checkedThis(this,'hdsa000101.hdsa000101036','hdsa000101.hdsa000101036','hdsa000101.hdsa000101037');checkBoxChecd('bls','2')"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101036-1"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >无</label>

                <input
                  id="gm_2"
                  type="checkbox"
                  onclick="checkedThis3(this,'hdsa000101.hdsa000101036','hdsa000101.hdsa000101037')"
                  name="hdsa000101.envrisklist[0].hdsa00010109002"
                  value="0,化学品"
                  style="font-size: 16px;"
                >
                化学品
                <input
                  id="gm_3"
                  type="checkbox"
                  onclick="checkedThis3(this,'hdsa000101.hdsa000101036','hdsa000101.hdsa000101037')"
                  name="hdsa000101.envrisklist[1].hdsa00010109002"
                  value="1,毒物"
                  style="font-size: 16px;"
                >
                毒物
                <input
                  id="gm_4"
                  type="checkbox"
                  onclick="checkedThis3(this,'hdsa000101.hdsa000101036','hdsa000101.hdsa000101037')"
                  name="hdsa000101.envrisklist[2].hdsa00010109002"
                  value="2,射线"
                  style="font-size: 16px;"
                >
                射线
              </span>
              <input
                id="hdsa000101.hdsa000101037"
                type="hidden"
                name="hdsa000101.hdsa000101037"
                value=""
                style="font-size: 16px;"
              >
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td width="42" rowspan="4" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">既往史</span>
            </td>
            <td align="center" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">疾病</span>
            </td>
            <td colspan="8" style="font-size: 16px;">
              <table id="jws_jb" width="100%" style="font-size: 16px;">
                <tbody style="font-size: 16px;">
                  <tr style="font-size: 16px;">
                    <td width="33%" class="STYLE2" style="font-size: 16px;">
                      <input
                        id="hdsa000101.hdsa000101039"
                        type="hidden"
                        name="hdsa000101.hdsa000101039"
                        value=""
                        style="font-size: 16px;"
                      >

                      <input
                        id="hdsa000101.hdsa000101038-1"
                        type="checkbox"
                        name="hdsa000101.hdsa000101038"
                        value="99"
                        checked="checked"
                        onclick="checkedThis4(this,'jws_jb')"
                        style="font-size: 16px;"
                      >
                      <label
                        for="hdsa000101.hdsa000101038-1"
                        class="checkboxLabel"
                        style="font-size: 16px;"
                      >无</label>
                    </td>
                    <td width="33%" class="STYLE2" style="font-size: 16px;">
                      <input
                        id="jb_2"
                        type="checkbox"
                        name="hdsa000101.diseasehistorylist[0].hdsa00010108002"
                        value="0,高血压"
                        onclick="checkedThis3(this,'hdsa000101.hdsa000101038','hdsa000101.hdsa000101039');isqtzz('jb_2','jwsjb1')"
                        style="font-size: 16px;"
                      >
                      高血压 确诊时间：
                      <input
                        id="jwsjb1"
                        type="text"
                        readonly="readonly"
                        value=""
                        name="hdsa000101.diseasehistorylist[0].hdsa00010108004"
                        onclick="isqtzz('jb_2','jwsjb1')"
                        onblur="dateValidation('jwsjb1')"
                        size="12"
                        title="时间格式:YYYY-MM"
                        maxlength="7"
                        style="font-size: 16px;"
                      >
                    </td>

                    <td width="33%" class="STYLE2" style="font-size: 16px;">
                      <input
                        id="jb_3"
                        type="checkbox"
                        name="hdsa000101.diseasehistorylist[1].hdsa00010108002"
                        value="1,糖尿病"
                        onclick="checkedThis3(this,'hdsa000101.hdsa000101038','hdsa000101.hdsa000101039');isqtzz('jb_3','jwsjb2')"
                        style="font-size: 16px;"
                      >
                      糖尿病 确诊时间：
                      <input
                        id="jwsjb2"
                        type="text"
                        readonly="readonly"
                        value=""
                        name="hdsa000101.diseasehistorylist[1].hdsa00010108004"
                        size="12"
                        title="时间格式:YYYY-MM"
                        maxlength="7"
                        onclick="isqtzz('jb_3','jwsjb2')"
                        onblur="dateValidation('jwsjb2')"
                        style="font-size: 16px;"
                      >
                    </td>
                  </tr>
                  <tr style="font-size: 16px;">
                    <td class="STYLE2" style="font-size: 16px;">
                      <input
                        id="jb_4"
                        type="checkbox"
                        value="2,冠心病"
                        name="hdsa000101.diseasehistorylist[2].hdsa00010108002"
                        onclick="checkedThis3(this,'hdsa000101.hdsa000101038','hdsa000101.hdsa000101039');isqtzz('jb_4','jwsjb3')"
                        style="font-size: 16px;"
                      >冠心病 确诊时间：
                      <input
                        id="jwsjb3"
                        type="text"
                        readonly="readonly"
                        value=""
                        name="hdsa000101.diseasehistorylist[2].hdsa00010108004"
                        size="12"
                        maxlength="7"
                        title="时间格式:YYYY-MM"
                        onclick="isqtzz('jb_4','jwsjb3')"
                        onblur="dateValidation('jwsjb3')"
                        style="font-size: 16px;"
                      >
                    </td>
                    <td class="STYLE2" style="font-size: 16px;">
                      <input
                        id="jb_5"
                        type="checkbox"
                        value="3,慢性阻塞性肺疾病"
                        name="hdsa000101.diseasehistorylist[3].hdsa00010108002"
                        onclick="checkedThis3(this,'hdsa000101.hdsa000101038','hdsa000101.hdsa000101039');isqtzz('jb_5','jwsjb4')"
                        style="font-size: 16px;"
                      >
                      慢性阻塞性肺疾病 确诊时间：
                      <input
                        id="jwsjb4"
                        type="text"
                        readonly="readonly"
                        value=""
                        name="hdsa000101.diseasehistorylist[3].hdsa00010108004"
                        size="12"
                        title="时间格式:YYYY-MM"
                        maxlength="7"
                        onclick="isqtzz('jb_5','jwsjb4')"
                        onblur="dateValidation('jwsjb4')"
                        style="font-size: 16px;"
                      >
                    </td>

                    <td class="STYLE2" style="font-size: 16px;">
                      <input
                        id="jb_6"
                        type="checkbox"
                        value="4,恶性肿瘤"
                        name="hdsa000101.diseasehistorylist[4].hdsa00010108002"
                        onclick="checkedThis3(this,'hdsa000101.hdsa000101038','hdsa000101.hdsa000101039');isqtzz('jb_6','jwsjb5')"
                        style="font-size: 16px;"
                      >恶性肿瘤 确诊时间：
                      <input
                        id="jwsjb5"
                        type="text"
                        readonly="readonly"
                        value=""
                        name="hdsa000101.diseasehistorylist[4].hdsa00010108004"
                        title="时间格式:YYYY-MM"
                        size="12"
                        maxlength="7"
                        onclick="isqtzz('jb_6','jwsjb5')"
                        onblur="dateValidation('jwsjb5')"
                        style="font-size: 16px;"
                      >
                    </td>
                  </tr>
                  <tr style="font-size: 16px;">
                    <td class="STYLE2" style="font-size: 16px;">
                      <input
                        id="jb_7"
                        type="checkbox"
                        value="5,脑卒中"
                        name="hdsa000101.diseasehistorylist[5].hdsa00010108002"
                        onclick="checkedThis3(this,'hdsa000101.hdsa000101038','hdsa000101.hdsa000101039');isqtzz('jb_7','jwsjb6')"
                        style="font-size: 16px;"
                      >脑卒中 确诊时间：
                      <input
                        id="jwsjb6"
                        type="text"
                        readonly="readonly"
                        value=""
                        name="hdsa000101.diseasehistorylist[5].hdsa00010108004"
                        size="12"
                        maxlength="7"
                        title="时间格式:YYYY-MM"
                        onclick="isqtzz('jb_7','jwsjb6')"
                        onblur="dateValidation('jwsjb6')"
                        style="font-size: 16px;"
                      >
                    </td>
                    <td class="STYLE2" style="font-size: 16px;">
                      <input
                        id="jb_8"
                        type="checkbox"
                        value="6,重性精神疾病 "
                        name="hdsa000101.diseasehistorylist[6].hdsa00010108002"
                        onclick="checkedThis3(this,'hdsa000101.hdsa000101038','hdsa000101.hdsa000101039');isqtzz('jb_8','jwsjb7')"
                        style="font-size: 16px;"
                      >
                      严重精神障碍 确诊时间：
                      <input
                        id="jwsjb7"
                        type="text"
                        readonly="readonly"
                        value=""
                        name="hdsa000101.diseasehistorylist[6].hdsa00010108004"
                        title="时间格式:YYYY-MM"
                        size="12"
                        maxlength="7"
                        onclick="isqtzz('jb_8','jwsjb7')"
                        onblur="dateValidation('jwsjb7')"
                        style="font-size: 16px;"
                      >
                    </td>
                    <td class="STYLE2" style="font-size: 16px;">
                      <input
                        id="jb_9"
                        type="checkbox"
                        value="7,结核病"
                        name="hdsa000101.diseasehistorylist[7].hdsa00010108002"
                        onclick="checkedThis3(this,'hdsa000101.hdsa000101038','hdsa000101.hdsa000101039');isqtzz('jb_9','jwsjb8')"
                        style="font-size: 16px;"
                      >
                      结核病 确诊时间：
                      <input
                        id="jwsjb8"
                        type="text"
                        readonly="readonly"
                        value=""
                        name="hdsa000101.diseasehistorylist[7].hdsa00010108004"
                        title="时间格式:YYYY-MM"
                        size="12"
                        maxlength="7"
                        onclick="isqtzz('jb_9','jwsjb8')"
                        onblur="dateValidation('jwsjb8')"
                        style="font-size: 16px;"
                      >
                    </td>
                  </tr>
                  <tr style="font-size: 16px;">
                    <td class="STYLE2" style="font-size: 16px;">
                      <input
                        id="jb_10"
                        type="checkbox"
                        value="8,肝炎"
                        name="hdsa000101.diseasehistorylist[8].hdsa00010108002"
                        onclick="checkedThis3(this,'hdsa000101.hdsa000101038','hdsa000101.hdsa000101039');isqtzz('jb_10','jwsjb9')"
                        style="font-size: 16px;"
                      >
                      肝炎 确诊时间：
                      <input
                        id="jwsjb9"
                        type="text"
                        readonly="readonly"
                        value=""
                        name="hdsa000101.diseasehistorylist[8].hdsa00010108004"
                        title="时间格式:YYYY-MM"
                        size="12"
                        maxlength="7"
                        onclick="isqtzz('jb_10','jwsjb9')"
                        onblur="dateValidation('jwsjb9')"
                        style="font-size: 16px;"
                      >
                    </td>

                    <td class="STYLE2" style="font-size: 16px;">
                      <input
                        id="jb_11"
                        type="checkbox"
                        value="9,其他法定传染病"
                        name="hdsa000101.diseasehistorylist[9].hdsa00010108002"
                        onclick="checkedThis3(this,'hdsa000101.hdsa000101038','hdsa000101.hdsa000101039');isqtzz('jb_11','jwsjb10')"
                        style="font-size: 16px;"
                      >
                      其他法定传染病 确诊时间：
                      <input
                        id="jwsjb10"
                        type="text"
                        readonly="readonly"
                        value=""
                        name="hdsa000101.diseasehistorylist[9].hdsa00010108004"
                        title="时间格式:YYYY-MM"
                        size="12"
                        maxlength="7"
                        onclick="isqtzz('jb_11','jwsjb10')"
                        onblur="dateValidation('jwsjb10')"
                        style="font-size: 16px;"
                      >
                    </td>

                    <td class="STYLE2" style="font-size: 16px;">
                      <input
                        id="jb_12"
                        type="checkbox"
                        value="10,职业病"
                        name="hdsa000101.diseasehistorylist[10].hdsa00010108002"
                        onclick="checkedThis3(this,'hdsa000101.hdsa000101038','hdsa000101.hdsa000101039');isqtzz('jb_12','jwsjb11')"
                        style="font-size: 16px;"
                      >
                      职业病 确诊时间：
                      <input
                        id="jwsjb11"
                        type="text"
                        readonly="readonly"
                        value=""
                        name="hdsa000101.diseasehistorylist[10].hdsa00010108004"
                        title="时间格式:YYYY-MM"
                        size="12"
                        maxlength="7"
                        onclick="isqtzz('jb_12','jwsjb11')"
                        onblur="dateValidation('jwsjb11')"
                        style="font-size: 16px;"
                      >
                    </td>
                  </tr>
                  <tr style="font-size: 16px;">
                    <td colspan="3" class="STYLE2" style="font-size: 16px;">
                      <input
                        id="jb_13"
                        type="checkbox"
                        value="11,其他"
                        name="hdsa000101.diseasehistorylist[11].hdsa00010108002"
                        onclick="checkedThis3(this,'hdsa000101.hdsa000101038','hdsa000101.hdsa000101039');isqtzz('jb_13','hdsa000101hdsa000101040','jwsjb12')"
                        style="font-size: 16px;"
                      >
                      其他

                      <input
                        id="hdsa000101hdsa000101040"
                        type="text"
                        readonly="readonly"
                        value=""
                        name="hdsa000101.hdsa000101040"
                        cssclass="line"
                        size="20"
                        style="font-size: 16px;"
                      >
                      确诊时间：
                      <input
                        id="jwsjb12"
                        type="text"
                        readonly="readonly"
                        value=""
                        name="hdsa000101.diseasehistorylist[11].hdsa00010108004"
                        title="时间格式:YYYY-MM"
                        size="12"
                        maxlength="7"
                        onclick="isqtzz('jb_13','jwsjb12')"
                        onblur="dateValidation('jwsjb12')"
                        style="font-size: 16px;"
                      >
                    </td>
                  </tr>
                </tbody>
              </table>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td width="68" align="center" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">手术</span>
            </td>
            <td colspan="8" style="font-size: 16px;">
              <table
                id="shoushutable"
                border="1"
                width="90%"
                style="font-size: 16px;"
              >
                <tbody style="font-size: 16px;">
                  <tr style="font-size: 16px;">
                    <td colspan="3" class="STYLE2" style="font-size: 16px;">
                      <input
                        id="hdsa000101.hdsa000101028"
                        type="hidden"
                        name="hdsa000101.hdsa000101028"
                        value=""
                        style="font-size: 16px;"
                      >

                      <input
                        id="hdsa000101.hdsa000101027-1"
                        type="checkbox"
                        name="hdsa000101.hdsa000101027"
                        value="0"
                        checked="checked"
                        onclick="checkedThis2Bygrda(this,'hdsa000101.hdsa000101027','hdsa000101.hdsa000101027','hdsa000101.hdsa000101028','hdsa00010104002','hdsa00010104004','shoushutable');isqtzz('hdsa000101.hdsa000101027-2','hdsa00010104002','hdsa00010104004')"
                        style="font-size: 16px;"
                      >
                      <label
                        for="hdsa000101.hdsa000101027-1"
                        class="checkboxLabel"
                        style="font-size: 16px;"
                      >无</label>
                      <input
                        id="hdsa000101.hdsa000101027-2"
                        type="checkbox"
                        name="hdsa000101.hdsa000101027"
                        value="1"
                        onclick="checkedThis2Bygrda(this,'hdsa000101.hdsa000101027','hdsa000101.hdsa000101027','hdsa000101.hdsa000101028','hdsa00010104002','hdsa00010104004','shoushutable');isqtzz('hdsa000101.hdsa000101027-2','hdsa00010104002','hdsa00010104004')"
                        style="font-size: 16px;"
                      >
                      <label
                        for="hdsa000101.hdsa000101027-2"
                        class="checkboxLabel"
                        style="font-size: 16px;"
                      >
                        有：</label>

                      名称：
                      <input
                        id="hdsa00010104002"
                        readonly="readonly"
                        name="hdsa000101.operationName"
                        type="text"
                        onclick="isqtzz('hdsa000101.hdsa000101027-2','hdsa00010104002','hdsa00010104004')"
                        class="line"
                        style="font-size: 16px;"
                      >
                      &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 手术时间：
                      <input
                        id="hdsa00010104004"
                        readonly="readonly"
                        name="hdsa000101.operationDtime"
                        title="时间格式:YYYY-MM"
                        onclick="isqtzz('hdsa000101.hdsa000101027-2','hdsa00010104002','hdsa00010104004')"
                        type="text"
                        maxlength="7"
                        onblur="dateValidation('hdsa00010104004')"
                        style="font-size: 16px;"
                      >
                      &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;
                      <input
                        id="button1"
                        name="button1"
                        type="button"
                        class="button blue small"
                        value="添加"
                        onclick="addRow('shoushutable','ophistorylist','hdsa00010104002','hdsa00010104004','hdsa000101')"
                        style="font-size: 16px;"
                      >
                      <font
                        color="red"
                        style="font-size: 16px;"
                      >录入信息后需点击添加！</font>
                    </td>
                  </tr>
                  <tr style="font-size: 16px;">
                    <td
                      width="50%"
                      align="center"
                      class="STYLE2"
                      style="font-size: 16px;"
                    >
                      名称
                    </td>
                    <td
                      width="25%"
                      align="center"
                      class="STYLE2"
                      style="font-size: 16px;"
                    >
                      手术时间
                    </td>
                    <td
                      width="20%"
                      align="center"
                      class="STYLE2"
                      style="font-size: 16px;"
                    >
                      操作
                    </td>
                  </tr>
                </tbody>
              </table>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td width="68" align="center" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">外伤</span>
            </td>
            <td colspan="8" style="font-size: 16px;">
              <table
                id="wstable"
                border="1"
                width="90%"
                style="font-size: 16px;"
              >
                <tbody style="font-size: 16px;">
                  <tr style="font-size: 16px;">
                    <td colspan="3" class="STYLE2" style="font-size: 16px;">
                      <input
                        id="hdsa000101.hdsa000101031"
                        type="hidden"
                        name="hdsa000101.hdsa000101031"
                        value=""
                        style="font-size: 16px;"
                      >

                      <input
                        id="hdsa000101.hdsa000101030-1"
                        type="checkbox"
                        name="hdsa000101.hdsa000101030"
                        value="0"
                        checked="checked"
                        onclick="checkedThis2Bygrda(this,'hdsa000101.hdsa000101030','hdsa000101.hdsa000101030','hdsa000101.hdsa000101031','hdsa00010105002','hdsa00010105003','wstable');isqtzz('hdsa000101.hdsa000101030-2','hdsa00010105002','hdsa00010105003')"
                        style="font-size: 16px;"
                      >
                      <label
                        for="hdsa000101.hdsa000101030-1"
                        class="checkboxLabel"
                        style="font-size: 16px;"
                      >无</label>
                      <input
                        id="hdsa000101.hdsa000101030-2"
                        type="checkbox"
                        name="hdsa000101.hdsa000101030"
                        value="1"
                        onclick="checkedThis2Bygrda(this,'hdsa000101.hdsa000101030','hdsa000101.hdsa000101030','hdsa000101.hdsa000101031','hdsa00010105002','hdsa00010105003','wstable');isqtzz('hdsa000101.hdsa000101030-2','hdsa00010105002','hdsa00010105003')"
                        style="font-size: 16px;"
                      >
                      <label
                        for="hdsa000101.hdsa000101030-2"
                        class="checkboxLabel"
                        style="font-size: 16px;"
                      >
                        有：</label>

                      名称：
                      <input
                        id="hdsa00010105002"
                        readonly="readonly"
                        name="hdsa000101.hdsa00010105002"
                        type="text"
                        onclick="isqtzz('hdsa000101.hdsa000101030-2','hdsa00010105002','hdsa00010105003')"
                        class="line"
                        style="font-size: 16px;"
                      >
                      &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 外伤时间：
                      <input
                        id="hdsa00010105003"
                        readonly="readonly"
                        name="hdsa000101.hdsa00010105003"
                        title="时间格式:YYYY-MM"
                        onclick="isqtzz('hdsa000101.hdsa000101030-2','hdsa00010105002','hdsa00010105003')"
                        type="text"
                        maxlength="7"
                        onblur="dateValidation('hdsa00010105003')"
                        style="font-size: 16px;"
                      >
                      &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;
                      <input
                        id="button2"
                        name="add"
                        type="button"
                        value="添加"
                        class="button blue small"
                        onclick="addRow('wstable','traumahistorylist','hdsa00010105002','hdsa00010105003','hdsa000101')"
                        style="font-size: 16px;"
                      >
                      <font color="red" style="font-size: 16px;">同上！</font>
                    </td>
                  </tr>
                  <tr style="font-size: 16px;">
                    <td
                      width="50%"
                      align="center"
                      class="STYLE2"
                      style="font-size: 16px;"
                    >
                      名称
                    </td>
                    <td
                      width="25%"
                      align="center"
                      class="STYLE2"
                      style="font-size: 16px;"
                    >
                      外伤时间
                    </td>
                    <td
                      width="20%"
                      align="center"
                      class="STYLE2"
                      style="font-size: 16px;"
                    >
                      操作
                    </td>
                  </tr>
                </tbody>
              </table>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td width="68" align="center" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">输血</span>
            </td>
            <td colspan="8" style="font-size: 16px;">
              <table
                id="sxtable"
                border="1"
                width="90%"
                style="font-size: 16px;"
              >
                <tbody style="font-size: 16px;">
                  <tr style="font-size: 16px;">
                    <td colspan="3" class="STYLE2" style="font-size: 16px;">
                      <input
                        id="hdsa000101.hdsa000101034"
                        type="hidden"
                        name="hdsa000101.hdsa000101034"
                        value=""
                        style="font-size: 16px;"
                      >

                      <input
                        id="hdsa000101.hdsa000101033-1"
                        type="checkbox"
                        name="hdsa000101.hdsa000101033"
                        value="0"
                        checked="checked"
                        onclick="checkedThis2Bygrda(this,'hdsa000101.hdsa000101033','hdsa000101.hdsa000101033','hdsa000101.hdsa000101034','hdsa00010103004','hdsa00010103006','sxtable');isqtzz('hdsa000101.hdsa000101033-2','hdsa00010103004','hdsa00010103006')"
                        style="font-size: 16px;"
                      >
                      <label
                        for="hdsa000101.hdsa000101033-1"
                        class="checkboxLabel"
                        style="font-size: 16px;"
                      >无</label>
                      <input
                        id="hdsa000101.hdsa000101033-2"
                        type="checkbox"
                        name="hdsa000101.hdsa000101033"
                        value="1"
                        onclick="checkedThis2Bygrda(this,'hdsa000101.hdsa000101033','hdsa000101.hdsa000101033','hdsa000101.hdsa000101034','hdsa00010103004','hdsa00010103006','sxtable');isqtzz('hdsa000101.hdsa000101033-2','hdsa00010103004','hdsa00010103006')"
                        style="font-size: 16px;"
                      >
                      <label
                        for="hdsa000101.hdsa000101033-2"
                        class="checkboxLabel"
                        style="font-size: 16px;"
                      >
                        有：</label>

                      原因：
                      <input
                        id="hdsa00010103004"
                        readonly="readonly"
                        name="hdsa000101.bloodTypeName"
                        type="text"
                        onclick="isqtzz('hdsa000101.hdsa000101033-2','hdsa00010103004','hdsa00010103006')"
                        class="line"
                        style="font-size: 16px;"
                      >
                      &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 输血时间：
                      <input
                        id="hdsa00010103006"
                        readonly="readonly"
                        name="hdsa000101.bloodTransfDTime"
                        title="时间格式:YYYY-MM"
                        onclick="isqtzz('hdsa000101.hdsa000101033-2','hdsa00010103004','hdsa00010103006')"
                        type="text"
                        maxlength="7"
                        class="line validate[custom[dateyymm]] text-input"
                        style="font-size: 16px;"
                      >
                      &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;
                      <input
                        id="button3"
                        name="add"
                        type="button"
                        value="添加"
                        class="button blue small"
                        onclick="addRow('sxtable','bloodtranslist','hdsa00010103004','hdsa00010103006','hdsa000101')"
                        style="font-size: 16px;"
                      >
                      <font color="red" style="font-size: 16px;">同上！</font>
                    </td>
                  </tr>
                  <tr style="font-size: 16px;">
                    <td
                      width="50%"
                      align="center"
                      class="STYLE2"
                      style="font-size: 16px;"
                    >
                      原因
                    </td>
                    <td
                      width="25%"
                      align="center"
                      class="STYLE2"
                      style="font-size: 16px;"
                    >
                      输血时间
                    </td>
                    <td
                      width="20%"
                      align="center"
                      class="STYLE2"
                      style="font-size: 16px;"
                    >
                      操作
                    </td>
                  </tr>
                </tbody>
              </table>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td colspan="2" rowspan="4" align="center" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">家族史</span>
            </td>
            <td align="left" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">父亲</span>
            </td>
            <td colspan="7" align="left" style="font-size: 16px;">
              <span
                id="jzs_fq"
                class="STYLE2"
                style="font-size: 16px;"
              ><input
                 id="fq1"
                 type="checkbox"
                 value="11,无"
                 name="hdsa000101.famhistorylist1[11].hdsa00010107002"
                 onclick="checkBoxChecd2('jzs_fq','0','hdsa000101hdsa00010107006')"
                 style="font-size: 16px;"
               >
                无
                <input
                  id="form1_hdsa000101_famhistorylist1_11__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[11].hdsa00010107004"
                  value="0"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist1_11__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[11].hdsa00010107005"
                  value="父亲"
                  style="font-size: 16px;"
                >

                <input
                  id="fq2"
                  onclick="checkBoxChecd2('jzs_fq','1','hdsa000101hdsa00010107006','','fq12')"
                  type="checkbox"
                  value="0,高血压"
                  name="hdsa000101.famhistorylist1[0].hdsa00010107002"
                  style="font-size: 16px;"
                >
                高血压
                <input
                  id="form1_hdsa000101_famhistorylist1_0__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[0].hdsa00010107004"
                  value="0"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist1_0__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[0].hdsa00010107005"
                  value="父亲"
                  style="font-size: 16px;"
                >

                <input
                  id="fq3"
                  onclick="checkBoxChecd2('jzs_fq','1','hdsa000101hdsa00010107006','','fq12')"
                  type="checkbox"
                  value="1,糖尿病"
                  name="hdsa000101.famhistorylist1[1].hdsa00010107002"
                  style="font-size: 16px;"
                >
                糖尿病
                <input
                  id="form1_hdsa000101_famhistorylist1_1__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[1].hdsa00010107004"
                  value="0"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist1_1__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[1].hdsa00010107005"
                  value="父亲"
                  style="font-size: 16px;"
                >

                <input
                  id="fq4"
                  onclick="checkBoxChecd2('jzs_fq','1','hdsa000101hdsa00010107006','','fq12')"
                  type="checkbox"
                  value="2,冠心病"
                  name="hdsa000101.famhistorylist1[2].hdsa00010107002"
                  style="font-size: 16px;"
                >
                冠心病
                <input
                  id="form1_hdsa000101_famhistorylist1_2__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[2].hdsa00010107004"
                  value="0"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist1_2__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[2].hdsa00010107005"
                  value="父亲"
                  style="font-size: 16px;"
                >

                <input
                  id="fq5"
                  onclick="checkBoxChecd2('jzs_fq','1','hdsa000101hdsa00010107006','','fq12')"
                  type="checkbox"
                  value="3,慢性阻塞性肺疾病"
                  name="hdsa000101.famhistorylist1[3].hdsa00010107002"
                  style="font-size: 16px;"
                >
                慢性阻塞性肺疾病
                <input
                  id="form1_hdsa000101_famhistorylist1_3__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[3].hdsa00010107004"
                  value="0"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist1_3__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[3].hdsa00010107005"
                  value="父亲"
                  style="font-size: 16px;"
                >

                <input
                  id="fq6"
                  onclick="checkBoxChecd2('jzs_fq','1','hdsa000101hdsa00010107006','','fq12')"
                  type="checkbox"
                  value="4,恶性肿瘤"
                  name="hdsa000101.famhistorylist1[4].hdsa00010107002"
                  style="font-size: 16px;"
                >
                恶性肿瘤
                <input
                  id="form1_hdsa000101_famhistorylist1_4__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[4].hdsa00010107004"
                  value="0"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist1_4__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[4].hdsa00010107005"
                  value="父亲"
                  style="font-size: 16px;"
                >

                <input
                  id="fq7"
                  onclick="checkBoxChecd2('jzs_fq','1','hdsa000101hdsa00010107006','','fq12')"
                  type="checkbox"
                  value="5,脑卒中"
                  name="hdsa000101.famhistorylist1[5].hdsa00010107002"
                  style="font-size: 16px;"
                >
                脑卒中
                <input
                  id="form1_hdsa000101_famhistorylist1_5__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[5].hdsa00010107004"
                  value="0"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist1_5__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[5].hdsa00010107005"
                  value="父亲"
                  style="font-size: 16px;"
                >

                <input
                  id="fq8"
                  onclick="checkBoxChecd2('jzs_fq','1','hdsa000101hdsa00010107006','','fq12')"
                  type="checkbox"
                  value="6,重性精神疾病"
                  name="hdsa000101.famhistorylist1[6].hdsa00010107002"
                  style="font-size: 16px;"
                >
                严重精神障碍
                <input
                  id="form1_hdsa000101_famhistorylist1_6__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[6].hdsa00010107004"
                  value="0"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist1_6__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[6].hdsa00010107005"
                  value="父亲"
                  style="font-size: 16px;"
                >

                <input
                  id="fq9"
                  onclick="checkBoxChecd2('jzs_fq','1','hdsa000101hdsa00010107006','','fq12')"
                  type="checkbox"
                  value="7,结核病"
                  name="hdsa000101.famhistorylist1[7].hdsa00010107002"
                  style="font-size: 16px;"
                >
                结核病
                <input
                  id="form1_hdsa000101_famhistorylist1_7__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[7].hdsa00010107004"
                  value="0"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist1_7__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[7].hdsa00010107005"
                  value="父亲"
                  style="font-size: 16px;"
                >

                <input
                  id="fq10"
                  onclick="checkBoxChecd2('jzs_fq','1','hdsa000101hdsa00010107006','','fq12')"
                  type="checkbox"
                  value="8,肝炎"
                  name="hdsa000101.famhistorylist1[8].hdsa00010107002"
                  style="font-size: 16px;"
                >
                肝炎
                <input
                  id="form1_hdsa000101_famhistorylist1_8__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[8].hdsa00010107004"
                  value="0"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist1_8__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[8].hdsa00010107005"
                  value="父亲"
                  style="font-size: 16px;"
                >

                <input
                  id="fq11"
                  onclick="checkBoxChecd2('jzs_fq','1','hdsa000101hdsa00010107006','','fq12')"
                  type="checkbox"
                  value="9,先天畸形"
                  name="hdsa000101.famhistorylist1[9].hdsa00010107002"
                  style="font-size: 16px;"
                >
                先天畸形
                <input
                  id="form1_hdsa000101_famhistorylist1_9__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[9].hdsa00010107004"
                  value="0"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist1_9__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[9].hdsa00010107005"
                  value="父亲"
                  style="font-size: 16px;"
                >

                <input
                  id="fq12"
                  onclick="checkBoxChecd2('jzs_fq','1','hdsa000101hdsa00010107006','','fq12');isqtzz('fq12','hdsa000101hdsa00010107006')"
                  type="checkbox"
                  value="10,其他"
                  name="hdsa000101.famhistorylist1[10].hdsa00010107002"
                  style="font-size: 16px;"
                >
                其他
                <input
                  id="hdsa000101hdsa00010107006"
                  type="text"
                  readonly="readonly"
                  value=""
                  name="hdsa000101.famhistorylist1[10].hdsa00010107006"
                  onclick="isqtzz('fq12','hdsa000101hdsa00010107006')"
                  cssclass="line"
                  size="13"
                  maxlength="50"
                  style="font-size: 16px;"
                >
                <input
                  id="form1_hdsa000101_famhistorylist1_10__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[10].hdsa00010107004"
                  value="0"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist1_10__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist1[10].hdsa00010107005"
                  value="父亲"
                  style="font-size: 16px;"
                >
              </span>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td align="left" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">母亲</span>
            </td>
            <td colspan="7" align="left" style="font-size: 16px;">
              <span
                id="jzs_mq"
                class="STYLE2"
                style="font-size: 16px;"
              ><input
                 id="mq1"
                 onclick="checkBoxChecd('jzs_mq','0','hdsa000101hdsa00010107006m')"
                 type="checkbox"
                 value="11,无"
                 name="hdsa000101.famhistorylist2[11].hdsa00010107002"
                 style="font-size: 16px;"
               >
                无
                <input
                  id="form1_hdsa000101_famhistorylist2_11__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[11].hdsa00010107004"
                  value="1"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist2_11__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[11].hdsa00010107005"
                  value="母亲"
                  style="font-size: 16px;"
                >

                <input
                  id="mq2"
                  onclick="checkBoxChecd2('jzs_mq','1','hdsa000101hdsa00010107006m','','mq12')"
                  type="checkbox"
                  value="0,高血压"
                  name="hdsa000101.famhistorylist2[0].hdsa00010107002"
                  style="font-size: 16px;"
                >
                高血压
                <input
                  id="form1_hdsa000101_famhistorylist2_0__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[0].hdsa00010107004"
                  value="1"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist2_0__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[0].hdsa00010107005"
                  value="母亲"
                  style="font-size: 16px;"
                >

                <input
                  id="mq3"
                  onclick="checkBoxChecd2('jzs_mq','1','hdsa000101hdsa00010107006m','','mq12')"
                  type="checkbox"
                  value="1,糖尿病"
                  name="hdsa000101.famhistorylist2[1].hdsa00010107002"
                  style="font-size: 16px;"
                >
                糖尿病
                <input
                  id="form1_hdsa000101_famhistorylist2_1__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[1].hdsa00010107004"
                  value="1"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist2_1__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[1].hdsa00010107005"
                  value="母亲"
                  style="font-size: 16px;"
                >

                <input
                  id="mq4"
                  onclick="checkBoxChecd2('jzs_mq','1','hdsa000101hdsa00010107006m','','mq12')"
                  type="checkbox"
                  value="2,冠心病"
                  name="hdsa000101.famhistorylist2[2].hdsa00010107002"
                  style="font-size: 16px;"
                >
                冠心病
                <input
                  id="form1_hdsa000101_famhistorylist2_2__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[2].hdsa00010107004"
                  value="1"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist2_2__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[2].hdsa00010107005"
                  value="母亲"
                  style="font-size: 16px;"
                >

                <input
                  id="mq5"
                  onclick="checkBoxChecd2('jzs_mq','1','hdsa000101hdsa00010107006m','','mq12')"
                  type="checkbox"
                  value="3,慢性阻塞性肺疾病"
                  name="hdsa000101.famhistorylist2[3].hdsa00010107002"
                  style="font-size: 16px;"
                >
                慢性阻塞性肺疾病
                <input
                  id="form1_hdsa000101_famhistorylist2_3__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[3].hdsa00010107004"
                  value="1"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist2_3__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[3].hdsa00010107005"
                  value="母亲"
                  style="font-size: 16px;"
                >

                <input
                  id="mq6"
                  onclick="checkBoxChecd2('jzs_mq','1','hdsa000101hdsa00010107006m','','mq12')"
                  type="checkbox"
                  value="4,恶性肿瘤"
                  name="hdsa000101.famhistorylist2[4].hdsa00010107002"
                  style="font-size: 16px;"
                >
                恶性肿瘤
                <input
                  id="form1_hdsa000101_famhistorylist2_4__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[4].hdsa00010107004"
                  value="1"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist2_4__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[4].hdsa00010107005"
                  value="母亲"
                  style="font-size: 16px;"
                >

                <input
                  id="mq7"
                  onclick="checkBoxChecd2('jzs_mq','1','hdsa000101hdsa00010107006m','','mq12')"
                  type="checkbox"
                  value="5,脑卒中"
                  name="hdsa000101.famhistorylist2[5].hdsa00010107002"
                  style="font-size: 16px;"
                >
                脑卒中
                <input
                  id="form1_hdsa000101_famhistorylist2_5__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[5].hdsa00010107004"
                  value="1"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist2_5__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[5].hdsa00010107005"
                  value="母亲"
                  style="font-size: 16px;"
                >

                <input
                  id="mq8"
                  onclick="checkBoxChecd2('jzs_mq','1','hdsa000101hdsa00010107006m','','mq12')"
                  type="checkbox"
                  value="6,重性精神疾病"
                  name="hdsa000101.famhistorylist2[6].hdsa00010107002"
                  style="font-size: 16px;"
                >
                严重精神障碍
                <input
                  id="form1_hdsa000101_famhistorylist2_6__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[6].hdsa00010107004"
                  value="1"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist2_6__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[6].hdsa00010107005"
                  value="母亲"
                  style="font-size: 16px;"
                >

                <input
                  id="mq9"
                  onclick="checkBoxChecd2('jzs_mq','1','hdsa000101hdsa00010107006m','','mq12')"
                  type="checkbox"
                  value="7,结核病"
                  name="hdsa000101.famhistorylist2[7].hdsa00010107002"
                  style="font-size: 16px;"
                >
                结核病
                <input
                  id="form1_hdsa000101_famhistorylist2_7__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[7].hdsa00010107004"
                  value="1"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist2_7__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[7].hdsa00010107005"
                  value="母亲"
                  style="font-size: 16px;"
                >

                <input
                  id="mq10"
                  onclick="checkBoxChecd2('jzs_mq','1','hdsa000101hdsa00010107006m','','mq12')"
                  type="checkbox"
                  value="8,肝炎"
                  name="hdsa000101.famhistorylist2[8].hdsa00010107002"
                  style="font-size: 16px;"
                >
                肝炎
                <input
                  id="form1_hdsa000101_famhistorylist2_8__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[8].hdsa00010107004"
                  value="1"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist2_8__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[8].hdsa00010107005"
                  value="母亲"
                  style="font-size: 16px;"
                >

                <input
                  id="mq11"
                  onclick="checkBoxChecd2('jzs_mq','1','hdsa000101hdsa00010107006m','','mq12')"
                  type="checkbox"
                  value="9,先天畸形"
                  name="hdsa000101.famhistorylist2[9].hdsa00010107002"
                  style="font-size: 16px;"
                >
                先天畸形
                <input
                  id="form1_hdsa000101_famhistorylist2_9__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[9].hdsa00010107004"
                  value="1"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist2_9__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[9].hdsa00010107005"
                  value="母亲"
                  style="font-size: 16px;"
                >

                <input
                  id="mq12"
                  onclick="checkBoxChecd2('jzs_mq','1','hdsa000101hdsa00010107006m','','mq12');isqtzz('mq12','hdsa000101hdsa00010107006m')"
                  type="checkbox"
                  value="10,其他"
                  name="hdsa000101.famhistorylist2[10].hdsa00010107002"
                  style="font-size: 16px;"
                >
                其他
                <input
                  id="hdsa000101hdsa00010107006m"
                  type="text"
                  readonly="readonly"
                  value=""
                  name="hdsa000101.famhistorylist2[10].hdsa00010107006"
                  onclick="isqtzz('mq12','hdsa000101hdsa00010107006m')"
                  cssclass="line"
                  size="13"
                  maxlength="50"
                  style="font-size: 16px;"
                >
                <input
                  id="form1_hdsa000101_famhistorylist2_10__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[10].hdsa00010107004"
                  value="1"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist2_10__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist2[10].hdsa00010107005"
                  value="母亲"
                  style="font-size: 16px;"
                >
              </span>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">兄弟姐妹</span>
            </td>
            <td colspan="7" style="font-size: 16px;">
              <span
                id="jzs_xm"
                class="STYLE2"
                style="font-size: 16px;"
              ><input
                 id="xm1"
                 onclick="checkBoxChecd('jzs_xm','0','hdsa000101hdsa00010107006x')"
                 type="checkbox"
                 value="11,无"
                 name="hdsa000101.famhistorylist3[11].hdsa00010107002"
                 style="font-size: 16px;"
               >
                无
                <input
                  id="form1_hdsa000101_famhistorylist3_11__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[11].hdsa00010107004"
                  value="2"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist3_11__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[11].hdsa00010107005"
                  value="兄弟姐妹"
                  style="font-size: 16px;"
                >

                <input
                  id="xm2"
                  onclick="checkBoxChecd2('jzs_xm','1','hdsa000101hdsa00010107006x','','xm12')"
                  type="checkbox"
                  value="0,高血压"
                  name="hdsa000101.famhistorylist3[0].hdsa00010107002"
                  style="font-size: 16px;"
                >
                高血压
                <input
                  id="form1_hdsa000101_famhistorylist3_0__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[0].hdsa00010107004"
                  value="2"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist3_0__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[0].hdsa00010107005"
                  value="兄弟姐妹"
                  style="font-size: 16px;"
                >

                <input
                  id="xm3"
                  onclick="checkBoxChecd2('jzs_xm','1','hdsa000101hdsa00010107006x','','xm12')"
                  type="checkbox"
                  value="1,糖尿病"
                  name="hdsa000101.famhistorylist3[1].hdsa00010107002"
                  style="font-size: 16px;"
                >
                糖尿病
                <input
                  id="form1_hdsa000101_famhistorylist3_1__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[1].hdsa00010107004"
                  value="2"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist3_1__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[1].hdsa00010107005"
                  value="兄弟姐妹"
                  style="font-size: 16px;"
                >

                <input
                  id="xm4"
                  onclick="checkBoxChecd2('jzs_xm','1','hdsa000101hdsa00010107006x','','xm12')"
                  type="checkbox"
                  value="2,冠心病"
                  name="hdsa000101.famhistorylist3[2].hdsa00010107002"
                  style="font-size: 16px;"
                >
                冠心病
                <input
                  id="form1_hdsa000101_famhistorylist3_2__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[2].hdsa00010107004"
                  value="2"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist3_2__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[2].hdsa00010107005"
                  value="兄弟姐妹"
                  style="font-size: 16px;"
                >

                <input
                  id="xm5"
                  onclick="checkBoxChecd2('jzs_xm','1','hdsa000101hdsa00010107006x','','xm12')"
                  type="checkbox"
                  value="3,慢性阻塞性肺疾病"
                  name="hdsa000101.famhistorylist3[3].hdsa00010107002"
                  style="font-size: 16px;"
                >
                慢性阻塞性肺疾病
                <input
                  id="form1_hdsa000101_famhistorylist3_3__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[3].hdsa00010107004"
                  value="2"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist3_3__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[3].hdsa00010107005"
                  value="兄弟姐妹"
                  style="font-size: 16px;"
                >

                <input
                  id="xm6"
                  onclick="checkBoxChecd2('jzs_xm','1','hdsa000101hdsa00010107006x','','xm12')"
                  type="checkbox"
                  value="4,恶性肿瘤"
                  name="hdsa000101.famhistorylist3[4].hdsa00010107002"
                  style="font-size: 16px;"
                >
                恶性肿瘤
                <input
                  id="form1_hdsa000101_famhistorylist3_4__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[4].hdsa00010107004"
                  value="2"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist3_4__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[4].hdsa00010107005"
                  value="兄弟姐妹"
                  style="font-size: 16px;"
                >

                <input
                  id="xm7"
                  onclick="checkBoxChecd2('jzs_xm','1','hdsa000101hdsa00010107006x','','xm12')"
                  type="checkbox"
                  value="5,脑卒中"
                  name="hdsa000101.famhistorylist3[5].hdsa00010107002"
                  style="font-size: 16px;"
                >
                脑卒中
                <input
                  id="form1_hdsa000101_famhistorylist3_5__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[5].hdsa00010107004"
                  value="2"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist3_5__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[5].hdsa00010107005"
                  value="兄弟姐妹"
                  style="font-size: 16px;"
                >

                <input
                  id="xm8"
                  onclick="checkBoxChecd2('jzs_xm','1','hdsa000101hdsa00010107006x','','xm12')"
                  type="checkbox"
                  value="6,重性精神疾病"
                  name="hdsa000101.famhistorylist3[6].hdsa00010107002"
                  style="font-size: 16px;"
                >
                严重精神障碍
                <input
                  id="form1_hdsa000101_famhistorylist3_6__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[6].hdsa00010107004"
                  value="2"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist3_6__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[6].hdsa00010107005"
                  value="兄弟姐妹"
                  style="font-size: 16px;"
                >

                <input
                  id="xm9"
                  onclick="checkBoxChecd2('jzs_xm','1','hdsa000101hdsa00010107006x','','xm12')"
                  type="checkbox"
                  value="7,结核病"
                  name="hdsa000101.famhistorylist3[7].hdsa00010107002"
                  style="font-size: 16px;"
                >
                结核病
                <input
                  id="form1_hdsa000101_famhistorylist3_7__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[7].hdsa00010107004"
                  value="2"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist3_7__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[7].hdsa00010107005"
                  value="兄弟姐妹"
                  style="font-size: 16px;"
                >

                <input
                  id="xm10"
                  onclick="checkBoxChecd2('jzs_xm','1','hdsa000101hdsa00010107006x','','xm12')"
                  type="checkbox"
                  value="8,肝炎"
                  name="hdsa000101.famhistorylist3[8].hdsa00010107002"
                  style="font-size: 16px;"
                >
                肝炎
                <input
                  id="form1_hdsa000101_famhistorylist3_8__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[8].hdsa00010107004"
                  value="2"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist3_8__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[8].hdsa00010107005"
                  value="兄弟姐妹"
                  style="font-size: 16px;"
                >

                <input
                  id="xm11"
                  onclick="checkBoxChecd2('jzs_xm','1','hdsa000101hdsa00010107006x','','xm12')"
                  type="checkbox"
                  value="9,先天畸形"
                  name="hdsa000101.famhistorylist3[9].hdsa00010107002"
                  style="font-size: 16px;"
                >
                先天畸形
                <input
                  id="form1_hdsa000101_famhistorylist3_9__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[9].hdsa00010107004"
                  value="2"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist3_9__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[9].hdsa00010107005"
                  value="兄弟姐妹"
                  style="font-size: 16px;"
                >

                <input
                  id="xm12"
                  onclick="checkBoxChecd2('jzs_xm','1','hdsa000101hdsa00010107006x','','xm12');isqtzz('xm12','hdsa000101hdsa00010107006x')"
                  type="checkbox"
                  value="10,其他"
                  name="hdsa000101.famhistorylist3[10].hdsa00010107002"
                  style="font-size: 16px;"
                >
                其他
                <input
                  id="hdsa000101hdsa00010107006x"
                  type="text"
                  readonly="readonly"
                  value=""
                  name="hdsa000101.famhistorylist3[10].hdsa00010107006"
                  onclick="isqtzz('xm12','hdsa000101hdsa00010107006x')"
                  cssclass="line"
                  size="13"
                  maxlength="50"
                  style="font-size: 16px;"
                >
                <input
                  id="form1_hdsa000101_famhistorylist3_10__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[10].hdsa00010107004"
                  value="2"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist3_10__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist3[10].hdsa00010107005"
                  value="兄弟姐妹"
                  style="font-size: 16px;"
                >
              </span>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">子女</span>
            </td>
            <td colspan="7" style="font-size: 16px;">
              <span
                id="jzs_zn"
                class="STYLE2"
                style="font-size: 16px;"
              ><input
                 id="zn1"
                 onclick="checkBoxChecd('jzs_zn','0','hdsa000101hdsa00010107006z')"
                 type="checkbox"
                 value="11,无"
                 name="hdsa000101.famhistorylist4[11].hdsa00010107002"
                 style="font-size: 16px;"
               >
                无
                <input
                  id="form1_hdsa000101_famhistorylist4_11__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[11].hdsa00010107004"
                  value="3"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist4_11__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[11].hdsa00010107005"
                  value="子女"
                  style="font-size: 16px;"
                >

                <input
                  id="zn2"
                  onclick="checkBoxChecd2('jzs_zn','1','hdsa000101hdsa00010107006z','','zn12')"
                  type="checkbox"
                  value="0,高血压"
                  name="hdsa000101.famhistorylist4[0].hdsa00010107002"
                  style="font-size: 16px;"
                >
                高血压
                <input
                  id="form1_hdsa000101_famhistorylist4_0__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[0].hdsa00010107004"
                  value="3"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist4_0__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[0].hdsa00010107005"
                  value="子女"
                  style="font-size: 16px;"
                >

                <input
                  id="zn3"
                  onclick="checkBoxChecd2('jzs_zn','1','hdsa000101hdsa00010107006z','','zn12')"
                  type="checkbox"
                  value="1,糖尿病"
                  name="hdsa000101.famhistorylist4[1].hdsa00010107002"
                  style="font-size: 16px;"
                >
                糖尿病
                <input
                  id="form1_hdsa000101_famhistorylist4_1__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[1].hdsa00010107004"
                  value="3"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist4_1__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[1].hdsa00010107005"
                  value="子女"
                  style="font-size: 16px;"
                >

                <input
                  id="zn4"
                  onclick="checkBoxChecd2('jzs_zn','1','hdsa000101hdsa00010107006z','','zn12')"
                  type="checkbox"
                  value="2,冠心病"
                  name="hdsa000101.famhistorylist4[2].hdsa00010107002"
                  style="font-size: 16px;"
                >
                冠心病
                <input
                  id="form1_hdsa000101_famhistorylist4_2__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[2].hdsa00010107004"
                  value="3"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist4_2__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[2].hdsa00010107005"
                  value="子女"
                  style="font-size: 16px;"
                >

                <input
                  id="zn5"
                  onclick="checkBoxChecd2('jzs_zn','1','hdsa000101hdsa00010107006z','','zn12')"
                  type="checkbox"
                  value="3,慢性阻塞性肺疾病"
                  name="hdsa000101.famhistorylist4[3].hdsa00010107002"
                  style="font-size: 16px;"
                >
                慢性阻塞性肺疾病
                <input
                  id="form1_hdsa000101_famhistorylist4_3__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[3].hdsa00010107004"
                  value="3"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist4_3__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[3].hdsa00010107005"
                  value="子女"
                  style="font-size: 16px;"
                >

                <input
                  id="zn6"
                  onclick="checkBoxChecd2('jzs_zn','1','hdsa000101hdsa00010107006z','','zn12')"
                  type="checkbox"
                  value="4,恶性肿瘤"
                  name="hdsa000101.famhistorylist4[4].hdsa00010107002"
                  style="font-size: 16px;"
                >
                恶性肿瘤
                <input
                  id="form1_hdsa000101_famhistorylist4_4__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[4].hdsa00010107004"
                  value="3"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist4_4__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[4].hdsa00010107005"
                  value="子女"
                  style="font-size: 16px;"
                >

                <input
                  id="zn7"
                  onclick="checkBoxChecd2('jzs_zn','1','hdsa000101hdsa00010107006z','','zn12')"
                  type="checkbox"
                  value="5,脑卒中"
                  name="hdsa000101.famhistorylist4[5].hdsa00010107002"
                  style="font-size: 16px;"
                >
                脑卒中
                <input
                  id="form1_hdsa000101_famhistorylist4_5__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[5].hdsa00010107004"
                  value="3"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist4_5__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[5].hdsa00010107005"
                  value="子女"
                  style="font-size: 16px;"
                >

                <input
                  id="zn8"
                  onclick="checkBoxChecd2('jzs_zn','1','hdsa000101hdsa00010107006z','','zn12')"
                  type="checkbox"
                  value="6,重性精神疾病"
                  name="hdsa000101.famhistorylist4[6].hdsa00010107002"
                  style="font-size: 16px;"
                >
                严重精神障碍
                <input
                  id="form1_hdsa000101_famhistorylist4_6__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[6].hdsa00010107004"
                  value="3"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist4_6__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[6].hdsa00010107005"
                  value="子女"
                  style="font-size: 16px;"
                >

                <input
                  id="zn9"
                  onclick="checkBoxChecd2('jzs_zn','1','hdsa000101hdsa00010107006z','','zn12')"
                  type="checkbox"
                  value="7,结核病"
                  name="hdsa000101.famhistorylist4[7].hdsa00010107002"
                  style="font-size: 16px;"
                >
                结核病
                <input
                  id="form1_hdsa000101_famhistorylist4_7__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[7].hdsa00010107004"
                  value="3"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist4_7__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[7].hdsa00010107005"
                  value="子女"
                  style="font-size: 16px;"
                >

                <input
                  id="zn10"
                  onclick="checkBoxChecd2('jzs_zn','1','hdsa000101hdsa00010107006z','','zn12')"
                  type="checkbox"
                  value="8,肝炎"
                  name="hdsa000101.famhistorylist4[8].hdsa00010107002"
                  style="font-size: 16px;"
                >
                肝炎
                <input
                  id="form1_hdsa000101_famhistorylist4_8__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[8].hdsa00010107004"
                  value="3"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist4_8__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[8].hdsa00010107005"
                  value="子女"
                  style="font-size: 16px;"
                >

                <input
                  id="zn11"
                  onclick="checkBoxChecd2('jzs_zn','1','hdsa000101hdsa00010107006z','','zn12')"
                  type="checkbox"
                  value="9,先天畸形"
                  name="hdsa000101.famhistorylist4[9].hdsa00010107002"
                  style="font-size: 16px;"
                >
                先天畸形
                <input
                  id="form1_hdsa000101_famhistorylist4_9__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[9].hdsa00010107004"
                  value="3"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist4_9__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[9].hdsa00010107005"
                  value="子女"
                  style="font-size: 16px;"
                >

                <input
                  id="zn12"
                  onclick="checkBoxChecd2('jzs_zn','1','hdsa000101hdsa00010107006z','','zn12');isqtzz('zn12','hdsa000101hdsa00010107006z')"
                  type="checkbox"
                  value="10,其他"
                  name="hdsa000101.famhistorylist4[10].hdsa00010107002"
                  style="font-size: 16px;"
                >
                其他
                <input
                  id="hdsa000101hdsa00010107006z"
                  type="text"
                  readonly="readonly"
                  value=""
                  name="hdsa000101.famhistorylist4[10].hdsa00010107006"
                  onclick="isqtzz('zn12','hdsa000101hdsa00010107006z')"
                  cssclass="line"
                  size="13"
                  maxlength="50"
                  style="font-size: 16px;"
                >
                <input
                  id="form1_hdsa000101_famhistorylist4_10__hdsa00010107004"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[10].hdsa00010107004"
                  value="3"
                  style="font-size: 16px;"
                >

                <input
                  id="form1_hdsa000101_famhistorylist4_10__hdsa00010107005"
                  type="hidden"
                  name="hdsa000101.famhistorylist4[10].hdsa00010107005"
                  value="子女"
                  style="font-size: 16px;"
                >
              </span>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td height="30" colspan="2" align="center" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">遗传病史</span>
            </td>
            <td colspan="8" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">
                <input
                  id="hdsa000101042"
                  type="hidden"
                  name="hdsa000101.hdsa000101042"
                  value=""
                  style="font-size: 16px;"
                >

                <input
                  id="hdsa000101.hdsa000101041-1"
                  type="checkbox"
                  name="hdsa000101.hdsa000101041"
                  value="0"
                  checked="checked"
                  onclick="checkedThisByJktj(this,'hdsa000101.hdsa000101041','hdsa000101.hdsa000101041','hdsa000101.hdsa000101042','hdsa000101043','','','','hdsa000101.hdsa000101041-2');"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101041-1"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >无</label>
                <input
                  id="hdsa000101.hdsa000101041-2"
                  type="checkbox"
                  name="hdsa000101.hdsa000101041"
                  value="1"
                  onclick="checkedThisByJktj(this,'hdsa000101.hdsa000101041','hdsa000101.hdsa000101041','hdsa000101.hdsa000101042','hdsa000101043','','','','hdsa000101.hdsa000101041-2');"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa000101.hdsa000101041-2"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >有</label>

                :疾病名称
                <input
                  id="hdsa000101043"
                  type="text"
                  name="hdsa000101.hdsa000101043"
                  readonly="readonly"
                  onclick="isqtzz('hdsa000101.hdsa000101041-2','hdsa000101043')"
                  class="line"
                  maxlength="50"
                  value=""
                  style="font-size: 16px;"
                >
              </span>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td height="30" colspan="2" align="center" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">残疾情况</span>
            </td>
            <td colspan="8" style="font-size: 16px;">
              <span
                id="cjqk"
                class="STYLE2"
                style="font-size: 16px;"
              ><input
                id="cj1"
                type="checkbox"
                value="0,无残疾"
                onclick="checkBoxChecd2('cjqk','0','hdsa000101046')"
                name="hdsa000101.disabilitylist[0].hdsa00010106002"
                checked="true"
                style="font-size: 16px;"
              >
                无残疾
                <input
                  id="cj2"
                  type="checkbox"
                  value="1,视力残疾"
                  onclick="checkBoxChecd2('cjqk','1','hdsa000101046','','cj8')"
                  name="hdsa000101.disabilitylist[1].hdsa00010106002"
                  style="font-size: 16px;"
                >
                视力残疾
                <input
                  id="cj3"
                  type="checkbox"
                  value="2,听力残疾"
                  onclick="checkBoxChecd2('cjqk','1','hdsa000101046','','cj8')"
                  name="hdsa000101.disabilitylist[2].hdsa00010106002"
                  style="font-size: 16px;"
                >
                听力残疾
                <input
                  id="cj4"
                  type="checkbox"
                  value="3,言语残疾"
                  onclick="checkBoxChecd2('cjqk','1','hdsa000101046','','cj8')"
                  name="hdsa000101.disabilitylist[3].hdsa00010106002"
                  style="font-size: 16px;"
                >
                言语残疾
                <input
                  id="cj5"
                  type="checkbox"
                  value="4,肢体残疾"
                  onclick="checkBoxChecd2('cjqk','1','hdsa000101046','','cj8')"
                  name="hdsa000101.disabilitylist[4].hdsa00010106002"
                  style="font-size: 16px;"
                >
                肢体残疾
                <input
                  id="cj6"
                  type="checkbox"
                  value="5,智力残疾"
                  onclick="checkBoxChecd2('cjqk','1','hdsa000101046','','cj8')"
                  name="hdsa000101.disabilitylist[5].hdsa00010106002"
                  style="font-size: 16px;"
                >
                智力残疾
                <input
                  id="cj7"
                  type="checkbox"
                  value="6,精神残疾"
                  onclick="checkBoxChecd2('cjqk','1','hdsa000101046','','cj8')"
                  name="hdsa000101.disabilitylist[6].hdsa00010106002"
                  style="font-size: 16px;"
                >
                精神残疾
                <input
                  id="cj8"
                  type="checkbox"
                  value="7,其他残疾"
                  onclick="checkBoxChecd2('cjqk','1','hdsa000101046','','cj8');isqtzz('cj8','hdsa000101046')"
                  name="hdsa000101.disabilitylist[7].hdsa00010106002"
                  style="font-size: 16px;"
                >
                其他残疾

                <input
                  id="hdsa000101046"
                  type="text"
                  onclick="isqtzz('cj8','hdsa000101046')"
                  readonly="readonly"
                  value=""
                  name="hdsa000101.hdsa000101046"
                  cssclass="line"
                  size="30"
                  maxlength="50"
                  style="font-size: 16px;"
                >
              </span>
            </td>
          </tr>

          <tr style="font-size: 16px;">
            <td colspan="2" align="center" height="30" style="font-size: 16px;">
              <span
                class="font_weight"
                style="font-size: 16px;"
              >与户主关系<font
                color="red"
                style="font-size: 16px;"
              >*</font></span>
            </td>
            <td colspan="8" style="font-size: 16px;">
              <span class="STYLE2" style="font-size: 16px;">
                <input
                  id="relationshipToHead"
                  type="hidden"
                  name="relationshipToHead"
                  value=""
                  style="font-size: 16px;"
                >

                <input
                  id="hdsa0001.hdsa0001022-1"
                  type="checkbox"
                  name="hdsa0001.hdsa0001022"
                  value="0"
                  onclick="checkedThisByJktj(this,'hdsa0001.hdsa0001022','hdsa0001.hdsa0001022','relationshipToHead','hdsa0001023','','','','hdsa0001.hdsa0001022-10')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa0001.hdsa0001022-1"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >本人</label>
                <input
                  id="hdsa0001.hdsa0001022-2"
                  type="checkbox"
                  name="hdsa0001.hdsa0001022"
                  value="1"
                  onclick="checkedThisByJktj(this,'hdsa0001.hdsa0001022','hdsa0001.hdsa0001022','relationshipToHead','hdsa0001023','','','','hdsa0001.hdsa0001022-10')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa0001.hdsa0001022-2"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >配偶</label>
                <input
                  id="hdsa0001.hdsa0001022-3"
                  type="checkbox"
                  name="hdsa0001.hdsa0001022"
                  value="2"
                  onclick="checkedThisByJktj(this,'hdsa0001.hdsa0001022','hdsa0001.hdsa0001022','relationshipToHead','hdsa0001023','','','','hdsa0001.hdsa0001022-10')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa0001.hdsa0001022-3"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >子</label>
                <input
                  id="hdsa0001.hdsa0001022-4"
                  type="checkbox"
                  name="hdsa0001.hdsa0001022"
                  value="3"
                  onclick="checkedThisByJktj(this,'hdsa0001.hdsa0001022','hdsa0001.hdsa0001022','relationshipToHead','hdsa0001023','','','','hdsa0001.hdsa0001022-10')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa0001.hdsa0001022-4"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >女</label>
                <input
                  id="hdsa0001.hdsa0001022-5"
                  type="checkbox"
                  name="hdsa0001.hdsa0001022"
                  value="32"
                  onclick="checkedThisByJktj(this,'hdsa0001.hdsa0001022','hdsa0001.hdsa0001022','relationshipToHead','hdsa0001023','','','','hdsa0001.hdsa0001022-10')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa0001.hdsa0001022-5"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >儿媳</label>
                <input
                  id="hdsa0001.hdsa0001022-6"
                  type="checkbox"
                  name="hdsa0001.hdsa0001022"
                  value="4"
                  onclick="checkedThisByJktj(this,'hdsa0001.hdsa0001022','hdsa0001.hdsa0001022','relationshipToHead','hdsa0001023','','','','hdsa0001.hdsa0001022-10')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa0001.hdsa0001022-6"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >孙子、孙女或外孙子、外孙女</label>
                <input
                  id="hdsa0001.hdsa0001022-7"
                  type="checkbox"
                  name="hdsa0001.hdsa0001022"
                  value="5"
                  onclick="checkedThisByJktj(this,'hdsa0001.hdsa0001022','hdsa0001.hdsa0001022','relationshipToHead','hdsa0001023','','','','hdsa0001.hdsa0001022-10')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa0001.hdsa0001022-7"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >父母</label>
                <input
                  id="hdsa0001.hdsa0001022-8"
                  type="checkbox"
                  name="hdsa0001.hdsa0001022"
                  value="6"
                  onclick="checkedThisByJktj(this,'hdsa0001.hdsa0001022','hdsa0001.hdsa0001022','relationshipToHead','hdsa0001023','','','','hdsa0001.hdsa0001022-10')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa0001.hdsa0001022-8"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >祖父母或外祖父母</label>
                <input
                  id="hdsa0001.hdsa0001022-9"
                  type="checkbox"
                  name="hdsa0001.hdsa0001022"
                  value="7"
                  onclick="checkedThisByJktj(this,'hdsa0001.hdsa0001022','hdsa0001.hdsa0001022','relationshipToHead','hdsa0001023','','','','hdsa0001.hdsa0001022-10')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa0001.hdsa0001022-9"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >兄弟姐妹</label>
                <input
                  id="hdsa0001.hdsa0001022-10"
                  type="checkbox"
                  name="hdsa0001.hdsa0001022"
                  value="8"
                  checked="checked"
                  onclick="checkedThisByJktj(this,'hdsa0001.hdsa0001022','hdsa0001.hdsa0001022','relationshipToHead','hdsa0001023','','','','hdsa0001.hdsa0001022-10')"
                  class="validate[required]"
                  style="font-size: 16px;"
                >
                <label
                  for="hdsa0001.hdsa0001022-10"
                  class="checkboxLabel"
                  style="font-size: 16px;"
                >其他</label>

                <input
                  id="hdsa0001023"
                  type="text"
                  readonly="readonly"
                  onclick="isqtzz('hdsa0001.hdsa0001022-10','hdsa0001023')"
                  value=""
                  name="hdsa0001.hdsa0001023"
                  cssclass="line"
                  size="20"
                  maxlength="50"
                  style="font-size: 16px;"
                >
              </span>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td rowspan="6" align="center" style="font-size: 16px;">
              生活环境
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td width="101" align="left" style="font-size: 16px;">
              厨房排风设施
            </td>
            <td colspan="9" style="font-size: 16px;">
              <input
                id="hdsa000201007"
                type="hidden"
                name="hdsa000201.hdsa000201007"
                value="无"
                style="font-size: 16px;"
              >

              <input
                id="hdsa000201.hdsa000201008-1"
                type="checkbox"
                name="hdsa000201.hdsa000201008"
                value="0"
                checked="checked"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201008','hdsa000201.hdsa000201008','hdsa000201007')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201008-1"
                class="checkboxLabel"
                style="font-size: 16px;"
              >无</label>
              <input
                id="hdsa000201.hdsa000201008-2"
                type="checkbox"
                name="hdsa000201.hdsa000201008"
                value="1"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201008','hdsa000201.hdsa000201008','hdsa000201007')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201008-2"
                class="checkboxLabel"
                style="font-size: 16px;"
              >油烟机</label>
              <input
                id="hdsa000201.hdsa000201008-3"
                type="checkbox"
                name="hdsa000201.hdsa000201008"
                value="2"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201008','hdsa000201.hdsa000201008','hdsa000201007')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201008-3"
                class="checkboxLabel"
                style="font-size: 16px;"
              >换风扇</label>
              <input
                id="hdsa000201.hdsa000201008-4"
                type="checkbox"
                name="hdsa000201.hdsa000201008"
                value="3"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201008','hdsa000201.hdsa000201008','hdsa000201007')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201008-4"
                class="checkboxLabel"
                style="font-size: 16px;"
              >烟囱</label>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td align="left" style="font-size: 16px;">燃料类型</td>
            <td colspan="9" style="font-size: 16px;">
              <input
                id="hdsa000201003"
                type="hidden"
                name="hdsa000201.hdsa000201003"
                value="液化气"
                style="font-size: 16px;"
              >

              <input
                id="hdsa000201.hdsa000201006-1"
                type="checkbox"
                name="hdsa000201.hdsa000201006"
                value="0"
                checked="checked"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201006','hdsa000201.hdsa000201006','hdsa000201003')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201006-1"
                class="checkboxLabel"
                style="font-size: 16px;"
              >液化气</label>
              <input
                id="hdsa000201.hdsa000201006-2"
                type="checkbox"
                name="hdsa000201.hdsa000201006"
                value="1"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201006','hdsa000201.hdsa000201006','hdsa000201003')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201006-2"
                class="checkboxLabel"
                style="font-size: 16px;"
              >煤</label>
              <input
                id="hdsa000201.hdsa000201006-3"
                type="checkbox"
                name="hdsa000201.hdsa000201006"
                value="2"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201006','hdsa000201.hdsa000201006','hdsa000201003')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201006-3"
                class="checkboxLabel"
                style="font-size: 16px;"
              >天然气</label>
              <input
                id="hdsa000201.hdsa000201006-4"
                type="checkbox"
                name="hdsa000201.hdsa000201006"
                value="3"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201006','hdsa000201.hdsa000201006','hdsa000201003')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201006-4"
                class="checkboxLabel"
                style="font-size: 16px;"
              >沼气</label>
              <input
                id="hdsa000201.hdsa000201006-5"
                type="checkbox"
                name="hdsa000201.hdsa000201006"
                value="4"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201006','hdsa000201.hdsa000201006','hdsa000201003')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201006-5"
                class="checkboxLabel"
                style="font-size: 16px;"
              >柴火</label>
              <input
                id="hdsa000201.hdsa000201006-6"
                type="checkbox"
                name="hdsa000201.hdsa000201006"
                value="5"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201006','hdsa000201.hdsa000201006','hdsa000201003')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201006-6"
                class="checkboxLabel"
                style="font-size: 16px;"
              >其他</label>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td align="left" style="font-size: 16px;">饮水</td>
            <td colspan="9" style="font-size: 16px;">
              <input
                id="hdsa000201001"
                type="hidden"
                name="hdsa000201.hdsa000201001"
                value="自来水"
                style="font-size: 16px;"
              >

              <input
                id="hdsa000201.hdsa000201002-1"
                type="checkbox"
                name="hdsa000201.hdsa000201002"
                value="0"
                checked="checked"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201002','hdsa000201.hdsa000201002','hdsa000201001')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201002-1"
                class="checkboxLabel"
                style="font-size: 16px;"
              >自来水</label>
              <input
                id="hdsa000201.hdsa000201002-2"
                type="checkbox"
                name="hdsa000201.hdsa000201002"
                value="1"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201002','hdsa000201.hdsa000201002','hdsa000201001')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201002-2"
                class="checkboxLabel"
                style="font-size: 16px;"
              >经净化过滤的水</label>
              <input
                id="hdsa000201.hdsa000201002-3"
                type="checkbox"
                name="hdsa000201.hdsa000201002"
                value="2"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201002','hdsa000201.hdsa000201002','hdsa000201001')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201002-3"
                class="checkboxLabel"
                style="font-size: 16px;"
              >井水</label>
              <input
                id="hdsa000201.hdsa000201002-4"
                type="checkbox"
                name="hdsa000201.hdsa000201002"
                value="3"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201002','hdsa000201.hdsa000201002','hdsa000201001')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201002-4"
                class="checkboxLabel"
                style="font-size: 16px;"
              >河湖水</label>
              <input
                id="hdsa000201.hdsa000201002-5"
                type="checkbox"
                name="hdsa000201.hdsa000201002"
                value="4"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201002','hdsa000201.hdsa000201002','hdsa000201001')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201002-5"
                class="checkboxLabel"
                style="font-size: 16px;"
              >塘水</label>
              <input
                id="hdsa000201.hdsa000201002-6"
                type="checkbox"
                name="hdsa000201.hdsa000201002"
                value="5"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201002','hdsa000201.hdsa000201002','hdsa000201001')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201002-6"
                class="checkboxLabel"
                style="font-size: 16px;"
              >其他</label>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td align="left" style="font-size: 16px;">厕所</td>
            <td colspan="9" style="font-size: 16px;">
              <input
                id="hdsa000201005"
                type="hidden"
                name="hdsa000201.hdsa000201005"
                value="卫生厕所"
                style="font-size: 16px;"
              >

              <input
                id="hdsa000201.hdsa000201004-1"
                type="checkbox"
                name="hdsa000201.hdsa000201004"
                value="0"
                checked="checked"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201004','hdsa000201.hdsa000201004','hdsa000201005')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201004-1"
                class="checkboxLabel"
                style="font-size: 16px;"
              >卫生厕所</label>
              <input
                id="hdsa000201.hdsa000201004-2"
                type="checkbox"
                name="hdsa000201.hdsa000201004"
                value="1"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201004','hdsa000201.hdsa000201004','hdsa000201005')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201004-2"
                class="checkboxLabel"
                style="font-size: 16px;"
              >一格或二格粪池式</label>
              <input
                id="hdsa000201.hdsa000201004-3"
                type="checkbox"
                name="hdsa000201.hdsa000201004"
                value="2"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201004','hdsa000201.hdsa000201004','hdsa000201005')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201004-3"
                class="checkboxLabel"
                style="font-size: 16px;"
              >马桶</label>
              <input
                id="hdsa000201.hdsa000201004-4"
                type="checkbox"
                name="hdsa000201.hdsa000201004"
                value="3"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201004','hdsa000201.hdsa000201004','hdsa000201005')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201004-4"
                class="checkboxLabel"
                style="font-size: 16px;"
              >露天粪坑</label>
              <input
                id="hdsa000201.hdsa000201004-5"
                type="checkbox"
                name="hdsa000201.hdsa000201004"
                value="4"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201004','hdsa000201.hdsa000201004','hdsa000201005')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201004-5"
                class="checkboxLabel"
                style="font-size: 16px;"
              >简易棚厕</label>
            </td>
          </tr>
          <tr style="font-size: 16px;">
            <td align="left" style="font-size: 16px;">禽畜栏</td>
            <td colspan="9" style="font-size: 16px;">
              <input
                id="hdsa000201009"
                type="hidden"
                name="hdsa000201.hdsa000201009"
                value="无"
                style="font-size: 16px;"
              >

              <input
                id="hdsa000201.hdsa000201010-1"
                type="checkbox"
                name="hdsa000201.hdsa000201010"
                value="0"
                checked="checked"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201010','hdsa000201.hdsa000201010','hdsa000201009')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201010-1"
                class="checkboxLabel"
                style="font-size: 16px;"
              >无</label>
              <input
                id="hdsa000201.hdsa000201010-2"
                type="checkbox"
                name="hdsa000201.hdsa000201010"
                value="1"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201010','hdsa000201.hdsa000201010','hdsa000201009')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201010-2"
                class="checkboxLabel"
                style="font-size: 16px;"
              >单设</label>
              <input
                id="hdsa000201.hdsa000201010-3"
                type="checkbox"
                name="hdsa000201.hdsa000201010"
                value="2"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201010','hdsa000201.hdsa000201010','hdsa000201009')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201010-3"
                class="checkboxLabel"
                style="font-size: 16px;"
              >室内</label>
              <input
                id="hdsa000201.hdsa000201010-4"
                type="checkbox"
                name="hdsa000201.hdsa000201010"
                value="3"
                disabled="disabled"
                onclick="checkedThis(this,'hdsa000201.hdsa000201010','hdsa000201.hdsa000201010','hdsa000201009')"
                style="font-size: 16px;"
              >
              <label
                for="hdsa000201.hdsa000201010-4"
                class="checkboxLabel"
                style="font-size: 16px;"
              >室外</label>
            </td>
          </tr>
        </tbody>
      </table>
    </form>
  </div>
</template>
<script>
import defaultSettings from '@/settings'

const title = defaultSettings.title || '公共卫生服务系统'
export default {
  created() {
    document.title = `预览家庭档案 - ${title}`
  }
}
</script>
<style lang="scss" scoped>
table {
  table-layout: fixed;
}
.preview{
  padding: 20px;
}
</style>
